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General NPI Number Information
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NPI Number | 1073686481
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Entity Type | Individual
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Provider Name | ANNA C. WALDEN PH.D.
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Gender | Female
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 08/13/2020
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Provider Practice Location Address
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Address Line | 991 AMIFORD DR
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City | SAN DIEGO
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State | CA
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Zip | 92107-4207
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Country | US
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Telephone | 619-733-1691
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Fax |
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Provider Business Mailing Address
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Address Line | 7548 SANTA MONICA AVE.
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City | SAN DIEGO
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State | CA
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Zip | 92167-0548
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Country | US
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Telephone | 619-733-1691
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Fax | 619-756-6456
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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 | PSY7846
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License Number State | CA
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