Healthcare Provider Details

I. General information

NPI: 1982938825
Provider Name (Legal Business Name): RUTH P NEWTON PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2009
Last Update Date: 09/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3252 HOLIDAY CT STE 109
LA JOLLA CA
92037-1807
US

IV. Provider business mailing address

3252 HOLIDAY CT STE 109
LA JOLLA CA
92037-1807
US

V. Phone/Fax

Practice location:
  • Phone: 858-458-0534
  • Fax: 619-281-2106
Mailing address:
  • Phone: 858-458-0534
  • Fax: 619-281-2106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY12117
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: