Individual
ELIZABETH SUE BAXTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3368 SECOND AVE, STE A1, SAN DIEGO, CA 92103-5666
(619) 297-7174
(619) 291-0901
Mailing address
3368 SECOND AVE, STE A1, SAN DIEGO, CA 92103-5666
(619) 297-7174
(619) 291-0901
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY6647
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PG0066470
—
CA
Enumeration date
08/05/2006
Last updated
08/03/2010
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