Healthcare Provider Details

I. General information

NPI: 1790267458
Provider Name (Legal Business Name): CAMILA ISABEL ZAGER PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2018
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9921 CARMEL MOUNTAIN RD STE 204
SAN DIEGO CA
92129-2813
US

IV. Provider business mailing address

1024 TOURMALINE ST
SAN DIEGO CA
92109-1834
US

V. Phone/Fax

Practice location:
  • Phone: 619-880-9008
  • Fax: 909-660-4997
Mailing address:
  • Phone: 619-786-4847
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY36521
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: