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General NPI Number Information
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NPI Number | 1649939208
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Entity Type | Individual
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Provider Name | KARIN THEBUS PSYD
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Gender | Female
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Dates
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Enumeration Date | 12/10/2021
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Last Update Date | 12/10/2021
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Provider Practice Location Address
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Address Line | 1337 CAMINO DEL MAR STE B
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City | DEL MAR
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State | CA
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Zip | 92014-2504
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Country | US
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Telephone | 858-733-1814
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7147
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City | RANCHO SANTA FE
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State | CA
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Zip | 92067-7147
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Country | US
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Telephone |
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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 | 33050
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License Number State | CA
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