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General NPI Number Information
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NPI Number | 1326535121
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Entity Type | Individual
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Provider Name | JENNIFER LING WANG-HALL PHD
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Gender | Female
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Dates
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Enumeration Date | 04/17/2018
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 21977 LONG TROT DR
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City | ESCONDIDO
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State | CA
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Zip | 92029-5936
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Country | US
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Telephone | 573-356-6904
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Fax |
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Provider Business Mailing Address
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Address Line | 314 N NEVADA ST UNIT 1
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City | OCEANSIDE
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State | CA
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Zip | 92054-2866
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Country | US
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Telephone | 573-356-6904
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Fax |
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY30374
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License Number State | CA
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