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General NPI Number Information
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NPI Number | 1902349731
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Entity Type | Organization
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Legal Business Name | ADRIANNE AHERN GRUNDLAND PHD PSYCHOLOGY CORPORATION
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Dates
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Enumeration Date | 11/28/2016
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 11622 EL CAMINO REAL SUITE 100
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City | SAN DIEGO
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State | CA
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Zip | 92130-2049
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Country | US
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Telephone | 858-764-2422
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Fax |
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Provider Business Mailing Address
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Address Line | 11622 EL CAMINO REAL SUITE 100
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City | SAN DIEGO
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State | CA
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Zip | 92130-2049
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Country | US
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Telephone | 858-764-2422
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | ADRIANNE AHERN GRUNDLAND
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Credential | PHD
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Telephone | 858-764-2422
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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 | PSY14473
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License Number State | CA
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