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Individual

HENGAMEH MOTAGHED

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD CLINICAL PSYCHOL

Contact information

Practice address
591 CAMINO DE LA REINA, 918, SAN DIEGO, CA 92108
(619) 969-6790
(619) 294-8190
Mailing address
3488 VOYAGER CIRCLE, SAN DIEGO, CA 92130
(619) 969-6790
(619) 294-8190

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY12707
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2810724
CA
Enumeration date
08/28/2006
Last updated
08/05/2010
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