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General NPI Number Information
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NPI Number | 1740251479
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Entity Type | Individual
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Provider Name | BEVERLY ANN DEXTER PH.D.
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Gender | Female
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Dates
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Enumeration Date | 01/31/2006
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | 11650 IBERIA PL STE 135
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City | SAN DIEGO
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State | CA
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Zip | 92128-2456
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Country | US
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Telephone | 858-442-9170
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Fax | 310-388-4948
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Provider Business Mailing Address
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Address Line | 11650 IBERIA PL STE 135
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City | SAN DIEGO
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State | CA
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Zip | 92128-2456
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Country | US
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Telephone | 858-376-7028
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Fax | 310-388-4948
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY 24088
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 24038
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 35-576
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License Number State | MS
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