Healthcare Provider Details

I. General information

NPI: 1235896044
Provider Name (Legal Business Name): PAUL HOBSON PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2021
Last Update Date: 07/17/2023
Certification Date: 07/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6386 ALVARADO CT STE 310
SAN DIEGO CA
92120-4908
US

IV. Provider business mailing address

6386 ALVARADO CT STE 310
SAN DIEGO CA
92120-4908
US

V. Phone/Fax

Practice location:
  • Phone: 858-634-8397
  • Fax: 619-668-6202
Mailing address:
  • Phone: 858-634-8397
  • Fax: 619-668-6202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number94026294
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number33771
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: