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NPI 1831405869

NPI 1831405869 : MARIETTE BOYCE PH.D. : ENCINITAS, CA

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General NPI Number Information
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    NPI Number           |    1831405869
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    Entity Type          |    Individual 
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    Provider Name        |    MARIETTE BOYCE PH.D.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/27/2010
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    Last Update Date     |    11/23/2015
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Provider Practice Location Address
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    Address Line         |    1991 VILLAGE PARK WAY STE. 100
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    City                 |    ENCINITAS
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    State                |    CA
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    Zip                  |    92024-1994
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    Country              |    US
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    Telephone            |    619-512-9123
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    Fax                  |    619-519-7079
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Provider Business Mailing Address
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    Address Line         |    6834 XANA WAY 
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    City                 |    CARLSBAD
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    State                |    CA
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    Zip                  |    92009-6030
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    Country              |    US
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    Telephone            |    619-512-9123
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    Fax                  |    619-519-7079
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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       |    PSY25424
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    License Number State |    CA
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