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3200 4th Ave Ste 100 San Diego CA 92103-5716 | |
| (619) 293-3994 | |
| (619) 260-1048 |
| Full Name | |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 3200 4th Ave Ste 100, San Diego, California |
| Authorized Official Name and Position | Catherine J Ward (SECRETARY / PSYCHOLOGIST) |
| Authorized Official Contact | 6192933994 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3200 4th Ave Ste 100 San Diego CA 92103-5716 Ph: (619) 293-3994 | 3200 4th Ave Ste 100 San Diego CA 92103-5716 Ph: (619) 293-3994 |
| NPI Number | 1902572167 |
|---|---|
| Provider Enumeration Date | 08/18/2021 |
| Last Update Date | 04/02/2024 |
| Certification Date | 04/02/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902572167 | NPI | - | NPPES |
| 1952608093 | Other | CA | NPI |
| PSY30926 | Other | CA | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | (* (Not Available)) | Primary |
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