Healthcare Provider Details

I. General information

NPI: 1043343635
Provider Name (Legal Business Name): LYNN DEUTSCH PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1270 NATIVIDAD RD
SALINAS CA
93906-3122
US

IV. Provider business mailing address

409 WALNUT ST
PACIFIC GROVE CA
93950-3928
US

V. Phone/Fax

Practice location:
  • Phone: 831-755-4510
  • Fax:
Mailing address:
  • Phone: 831-646-9537
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY13615
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: