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General NPI Number Information
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NPI Number | 1215592886
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Entity Type | Organization
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Legal Business Name | COLETTE LORD PHD PSYCHOLOGIST INC.
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Dates
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Enumeration Date | 05/08/2019
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | 317 14TH ST STE E
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City | DEL MAR
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State | CA
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Zip | 92014-2554
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Country | US
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Telephone | 858-276-8831
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Fax | 858-215-5459
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Provider Business Mailing Address
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Address Line | 3790 VIA DE LA VALLE STE 120E
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City | DEL MAR
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State | CA
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Zip | 92014-4248
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Country | US
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Telephone | 858-276-8831
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Fax | 833-342-3792
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | COLETTE LORD
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Credential | PHD
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Telephone | 858-276-8831
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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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