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Organization

RADY CHILDREN'S HOSPITAL

Active
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Organization

RADY CHILDREN'S HOSPITAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. CHRISTINE FOREST (CONTRACT SPECIALIST)
(858) 966-7716
Entity
Organization

Contact information

Practice address
3020 CHILDRENS WAY # MC5081, SAN DIEGO, CA 92123-4223
(858) 576-1700
(858) 966-8495
Mailing address
3020 CHILDRENS WAY, SAN DIEGO, CA 92123-4223
(858) 576-1700
(858) 966-8495

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY22035
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZH3702Z
BLUE SHIELD GROUP PROVIDER NUMBER
CA
Enumeration date
03/18/2009
Last updated
03/18/2009
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