MEDICARE: DR. KATHLEEN FRANCES GARROVA PSY.D.MSN,MA,RN

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
1	103TC0700X	Clinical Psychologist	PSY 20086	CA

General Provider Information

NPI Number	:	1730234196
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATHLEEN FRANCES GARROVA PSY.D.MSN,MA,RN

Provider Business Mailing Address
First Line	:	10296 RUE CHAMONIX
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92131-2612
Country	:	US
Telephone Number	:	858-213-5774
Fax Number	:

Provider Business Practice Location Address
First Line	:	9968 HIBERT ST
Second Line	:	SUITE 101
City	:	SAN DIEGO
State	:	CA
Zip	:	92131-1035
Country	:	US
Telephone Number	:	858-213-5774
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2007
Last Update Date	:	07/08/2007

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