MEDICARE: DR. ROSEMARY PARRISH HODGES 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	103TC2200X	Clinical Child & Adolescent Psychologist	PSY36797	CA
2	103TC2200X	Clinical Child & Adolescent Psychologist	PSY005382	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720586076
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROSEMARY PARRISH HODGES PSYD

Provider Business Mailing Address
First Line	:	3020 CHILDRENS WAY
Second Line	:	MC5003
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-4223
Country	:	US
Telephone Number	:	858-576-1700
Fax Number	:

Provider Business Practice Location Address
First Line	:	3010 CHILDRENS WAY
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-4223
Country	:	US
Telephone Number	:	858-576-1700
Fax Number	:

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

Provider Enumeration Date	:	01/31/2018
Last Update Date	:	06/12/2026

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