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General NPI Number Information
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NPI Number | 1831318500
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Entity Type | Organization
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Legal Business Name | DEVELOPMENTAL SPECIALISTS OF SOUTHERN CALIFORNIA
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 9320 CHESAPEAKE DR SUITE 214
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City | SAN DIEGO
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State | CA
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Zip | 92123-1029
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Country | US
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Telephone | 858-581-5053
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Fax | 858-274-0348
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Provider Business Mailing Address
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Address Line | 9320 CHESAPEAKE DR SUITE 214
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City | SAN DIEGO
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State | CA
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Zip | 92123-1029
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Country | US
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Telephone | 858-581-5053
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Fax | 858-274-0348
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Authorized Official
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Title or Position | OWNER
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Name | DEBORAH G MISHEK
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Credential | M.D.
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Telephone | 858-581-5053
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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 | PSY17217
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCS22041
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License Number State | CA
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