Individual
JEROLD SCOTT PHELPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
9500 GILMAN DRIVE 0304, LA JOLLA, CA 92093-0304
(858) 822-2614
(858) 534-2628
Mailing address
9500 GILMAN DRIVE 0304, LA JOLLA, CA 92093-0304
(858) 822-2614
(858) 534-2628
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY15347
CA
103TC0700X
Clinical Psychologist
PSY15347
CA
Other
Enumeration date
04/29/2008
Last updated
04/29/2008
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