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General NPI Number Information
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NPI Number | 1740315043
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Entity Type | Individual
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Provider Name | NATACHA AKSHOOMOFF PH.D.
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Gender | Female
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Dates
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Enumeration Date | 02/23/2007
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Last Update Date | 06/02/2023
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Provider Practice Location Address
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Address Line | 12625 HIGH BLUFF DRIVE SUITE 215
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City | SAN DIEGO
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State | CA
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Zip | 92130
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Country | US
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Telephone | 760-230-3439
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Fax | 858-792-8333
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Provider Business Mailing Address
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Address Line | 1313 WINDSOR ROAD
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City | CARDIFF
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State | CA
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Zip | 92007
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Country | US
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Telephone | 760-230-3439
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY17720
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | PSY17720
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License Number State | CA
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