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Organization

BASTYR UNIVERSITY

Active
Parent organization
BASTYR UNIVERSITY
Other names
Bastyr University Clinic
Organization subpart
Yes

Provider details

NPI number
Legal business name
BASTYR UNIVERSITY
Authorized official
MS. MOIRA PYLE FITZPATRICK PHD, ND (VICE PRESIDENT)
(858) 246-9701
Entity
Organization

Contact information

Practice address
4106 SORRENTO VALLEY BLVD, SAN DIEGO, CA 92121-1407
(858) 246-9730
(858) 246-9710
Mailing address
4106 SORRENTO VALLEY BLVD, SAN DIEGO, CA 92121-1407
(858) 246-9730
(858) 246-9710

Taxonomy

Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
PSY11413
CA
175F00000X
Naturopath
Primary
ND-556
CA

Other

Enumeration date
11/15/2012
Last updated
11/15/2012
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