Healthcare Provider Details

I. General information

NPI: 1013905330
Provider Name (Legal Business Name): CHARLENE HARVEY HOAR ED.D., CADC-II
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/11/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

386 13TH ST
DEL MAR CA
92014-2555
US

IV. Provider business mailing address

386 13TH ST
DEL MAR CA
92014-2555
US

V. Phone/Fax

Practice location:
  • Phone: 858-794-0546
  • Fax: 858-794-0531
Mailing address:
  • Phone: 858-794-0546
  • Fax: 858-794-0531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY 5747
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: