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Organization
UNIVERSITY OF CALIFORNIA, SAN DIEGO
Active
Organization
UNIVERSITY OF CALIFORNIA, SAN DIEGO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA PANNIZON PSY D. (ASSISTANT PROGRAM DIRECTOR)
(619) 542-4156
Entity
Organization
Contact information
Practice address
3851 ROSECRANS ST, SAN DIEGO, CA 92110-3115
(619) 542-4156
Mailing address
11223 PASEO MONTANOSO APT 282, SAN DIEGO, CA 92127-5953
(760) 518-3119
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
390200000
CA
Other
Enumeration date
07/27/2012
Last updated
07/27/2012
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