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General NPI Number Information
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NPI Number | 1750379400
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Entity Type | Organization
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Legal Business Name | CORINNA YOUNG CASEY PH D PSYCHOLOGY
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Dates
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Enumeration Date | 10/07/2005
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Last Update Date | 08/16/2016
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Provider Practice Location Address
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Address Line | 2262 CARMEL VALLEY RD SUITE E
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City | DEL MAR
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State | CA
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Zip | 92014-3751
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Country | US
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Telephone | 858-794-9413
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Fax | 858-876-3128
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Provider Business Mailing Address
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Address Line | 2262 CARMEL VALLEY RD SUITE E
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City | DEL MAR
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State | CA
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Zip | 92014-3751
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Country | US
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Telephone | 858-794-9413
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Fax | 858-876-3128
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CORINNA YOUNG CASEY
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Credential | PH.D.
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Telephone | 858-794-9413
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TH0100X
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Taxonomy Name | Health Service Psychologist
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License Number | PSY20004
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY20004
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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 | PSY20004
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License Number State | CA
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