Individual
DR. BRUCE CARROLL BAXLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
4405 MANCHESTER AVE STE 206, ENCINITAS, CA 92024-7902
(858) 271-3060
Mailing address
PO BOX 964, SOLANA BEACH, CA 92075-0964
(858) 271-3060
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY6399
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PSY063990
—
CA
Enumeration date
01/28/2007
Last updated
09/30/2019
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