Individual
AMANDA ALEXANDRA TOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9500 GILMAN DR, LA JOLLA, CA 92093-5004
(858) 534-3755
Mailing address
3298 GOVERNOR DRIVE, PO BOX 22988, SAN DIEGO, CA 92122
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY34190
CA
Other
Enumeration date
10/04/2024
Last updated
10/04/2024
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