MEDICARE: DR. PAMELA J NEWMAN PSYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PSY32085	CA

General Provider Information

NPI Number	:	1588261580
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAMELA J NEWMAN PSYD

Provider Business Mailing Address
First Line	:	2635 CAMINO DEL RIO S STE 302
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-3729
Country	:	US
Telephone Number	:	858-480-1960
Fax Number	:

Provider Business Practice Location Address
First Line	:	2635 CAMINO DEL RIO S
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-3726
Country	:	US
Telephone Number	:	858-480-1960
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2020
Last Update Date	:	06/13/2021

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