Healthcare Provider Details

I. General information

NPI: 1326749979
Provider Name (Legal Business Name): ANJELI DESMOND PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANJELI DESMOND PHD

II. Dates (important events)

Enumeration Date: 03/10/2023
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36A UPPER CIR
CARMEL VALLEY CA
93924-9773
US

IV. Provider business mailing address

36A UPPER CIR
CARMEL VALLEY CA
93924-9773
US

V. Phone/Fax

Practice location:
  • Phone: 831-202-2560
  • Fax:
Mailing address:
  • Phone: 831-202-2560
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0810009453
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: