Individual
DR. ELLEN LAVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
3350 LA JOLLA VILLAGE DR, 116B, SAN DIEGO, CA 92161-0002
(858) 552-8585
Mailing address
3350 LA JOLLA VILLAGE DRIVE, 116B, SAN DIEGO, CA 92161
(858) 552-8585
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
PSY16244
CA
103TA0400X
Addiction (Substance Use Disorder) Psychologist
PSY16244
CA
103TB0200X
Cognitive & Behavioral Psychologist
PSY16244
CA
103TC0700X
Clinical Psychologist
Primary
PSY16244
CA
103TH0100X
Health Service Psychologist
PSY16244
CA
103TP2701X
Group Psychotherapy Psychologist
PSY16244
CA
Other
Enumeration date
07/05/2006
Last updated
07/18/2007
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