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General NPI Number Information
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NPI Number | 1023543527
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Entity Type | Individual
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Provider Name | STEPHEN DANIEL SPRINKLE PH.D.
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Gender | Male
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Dates
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Enumeration Date | 04/22/2017
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Last Update Date | 05/22/2020
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Provider Practice Location Address
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Address Line | 3252 HOLIDAY CT STE 201
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City | LA JOLLA
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State | CA
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Zip | 92037-1808
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Country | US
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Telephone | 858-349-6576
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Fax | 858-777-9609
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Provider Business Mailing Address
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Address Line | 12468 CARMEL POINTE
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City | SAN DIEGO
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State | CA
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Zip | 92130-2268
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Country | US
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Telephone | 858-349-6576
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Fax | 858-777-9609
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY 21849
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License Number State | CA
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