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General NPI Number Information
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NPI Number | 1619477767
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Entity Type | Individual
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Provider Name | DR. PHILIP WATSON
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Gender | Male
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Dates
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Enumeration Date | 02/15/2018
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 12625 HIGH BLUFF DR STE 216
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City | SAN DIEGO
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State | CA
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Zip | 92130-2054
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Country | US
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Telephone | 760-635-3310
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Fax | 760-230-9291
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Provider Business Mailing Address
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Address Line | 12625 HIGH BLUFF DR STE 216
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City | SAN DIEGO
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State | CA
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Zip | 92130-2054
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Country | US
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Telephone | 760-635-3310
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Fax | 760-230-9291
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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 | 35748
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License Number State | CA
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