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General NPI Number Information
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NPI Number | 1932200607
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Entity Type | Individual
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Provider Name | SUZANNE GERE PH. D.
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Gender | Female
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 09/04/2012
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Provider Practice Location Address
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Address Line | 2382 FARADAY AVE SUITE 250
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City | CARLSBAD
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State | CA
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Zip | 92008-7218
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Country | US
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Telephone | 760-815-8585
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Fax | 760-230-1074
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Provider Business Mailing Address
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Address Line | 1252 RUBENSTEIN AVE.
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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 | 760-815-8585
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Fax | 760-230-1074
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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 | PSY 15773
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License Number State | CA
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