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General NPI Number Information
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NPI Number | 1548306269
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Entity Type | Individual
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Provider Name | JOHN LAWRENCE HESSLER PH.D.
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Gender | Male
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 815 3RD AVE 107
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City | CHULA VISTA
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State | CA
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Zip | 91911-1307
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Country | US
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Telephone | 619-426-1555
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Fax | 619-426-1906
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Provider Business Mailing Address
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Address Line | 3329 2ND AVE
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City | SAN DIEGO
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State | CA
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Zip | 92103-5611
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Country | US
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Telephone | 619-298-7488
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Fax | 619-298-7488
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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 | PSY 9643
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License Number State | CA
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