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NPI Code Detail

MEDICARE: DR. LYNN WARNER PH.D.

MEDICARE: DR. LYNN WARNER PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist0810001729VA
2103T00000XPsychologistPSY30310CA

General Provider Information

NPI Number : 1710143086
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LYNN WARNER PH.D.
Provider Business Mailing Address
First Line : 4040 HANCOCK ST APT 1006
Second Line :
City : SAN DIEGO
State : CA
Zip : 92110-5112
Country : US
Telephone Number : 757-870-7577
Fax Number :
Provider Business Practice Location Address
First Line : 5252 BALBOA AVE STE 800
Second Line :
City : SAN DIEGO
State : CA
Zip : 92117-6970
Country : US
Telephone Number : 757-870-7577
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2008
Last Update Date : 07/22/2022

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