Individual
DR. ELIZABETH EARLE GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3921 GOLDFINCH ST, SAN DIEGO, CA 92103-2926
(619) 260-0335
(619) 260-1682
Mailing address
3921 GOLDFINCH ST, SAN DIEGO, CA 92103-2926
(619) 260-0335
(619) 260-1682
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY15277
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OPL152770
BLUE SHIELD
CA
01
—
PSY15277
LICENSE
CA
05
—
PSY152770
—
CA
Enumeration date
07/28/2005
Last updated
07/21/2022
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