Individual
DR. LAWRENCE TODD WOODBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
9255 TOWNE CENTRE DR, SUITE 370, SAN DIEGO, CA 92121-3033
(760) 434-2242
Mailing address
5670 DOLPHIN PL, LA JOLLA, CA 92037-7517
(760) 434-2242
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY 5312
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00PL53120
—
CA
Enumeration date
11/25/2006
Last updated
07/08/2007
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