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General NPI Number Information
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NPI Number | 1093543423
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Entity Type | Organization
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Legal Business Name | STEPHANIE A MASSEY
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Dates
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Enumeration Date | 07/25/2024
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Last Update Date | 07/25/2024
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Provider Practice Location Address
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Address Line | 12625 HIGH BLUFF DR STE 206
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City | SAN DIEGO
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State | CA
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Zip | 92130-2053
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Country | US
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Telephone | 619-654-4392
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Fax | 619-448-8954
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Provider Business Mailing Address
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Address Line | 9395 HARRITT RD SPC 261
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City | LAKESIDE
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State | CA
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Zip | 92040-3536
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Country | US
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Telephone | 619-654-4392
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Fax | 619-448-8954
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Authorized Official
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Title or Position | OWNER/AUTHORIZED OFFICIAL
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Name | STEPHANIE ANN MASSEY
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Credential |
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Telephone | 619-654-4392
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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 |
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License Number State |
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