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Organization
RADY CHILDREN'S HOSPITAL SAN DIEGO
Active
Organization
RADY CHILDREN'S HOSPITAL SAN DIEGO
Active
Other names
Developmental Evaluation Clinci
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFERY R. OLSON PH.D. (SUPERVISOR DEV SRVS OPERATIONS)
(858) 966-5416
Entity
Organization
Contact information
Practice address
8010 FROST ST., STE 200, SAN DIEGO, CA 92123
(858) 966-5817
(858) 966-8528
Mailing address
3020 CHILDRENS WAY, MC5023, SAN DIEGO, CA 92123-4223
(858) 966-5817
(858) 966-8528
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
—
282NC2000X
Children's Hospital
Primary
080000028
CA
282NC2000X
Children's Hospital
PSY11584
CA
Other
Enumeration date
11/29/2006
Last updated
06/03/2011
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