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General NPI Number Information
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NPI Number | 1083863559
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Entity Type | Organization
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Legal Business Name | UCSD DEPT. OF PSYCHIATRY
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Dates
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Enumeration Date | 09/09/2008
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Last Update Date | 09/09/2008
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Provider Practice Location Address
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Address Line | 140 ARBOR DR # MC0851
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City | SAN DIEGO
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State | CA
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Zip | 92103-2007
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Country | US
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Telephone | 619-497-6647
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Fax |
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Provider Business Mailing Address
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Address Line | 140 ARBOR DR # MC0851
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City | SAN DIEGO
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State | CA
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Zip | 92103-2007
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Country | US
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Telephone | 619-497-6647
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Fax |
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Authorized Official
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Title or Position | ASSOCIATE CLINICAL SOCIAL WORKER
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Name | ROSEANN LARSON
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Credential | M.S.W.
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Telephone | 619-497-6653
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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