Individual
DR. AUTUMN LOREENE BACKHAUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
3350 LA JOLLA VILLAGE DR, PSYCHOLOGY SERVICE, SAN DIEGO, CA 92161-0002
(858) 401-3827
Mailing address
3350 LA JOLLA VILLAGE DR, PSYCHOLOGY SERVICE, SAN DIEGO, CA 92161-0002
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY24346
CA
Other
Enumeration date
10/11/2011
Last updated
10/11/2011
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