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Individual

ANIEL PONCE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
11650 IBERIA PL STE 130, SAN DIEGO, CA 92128-2431
(858) 264-5858
(858) 649-6012
Mailing address
PO BOX 8488, PASADENA, CA 91109-8607
(858) 264-5858
(858) 649-6012

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
33407
CA

Other

Enumeration date
04/27/2016
Last updated
06/14/2022
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