Organization
FAWCETT PSYCHOLOGY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN FAWCETT PH.D. (PRESIDENT)
(619) 306-0811
Entity
Organization
Contact information
Practice address
3604 4TH AVE STE 5, SAN DIEGO, CA 92103-4118
(619) 356-0811
Mailing address
4625 SANTA MONICA AVE, SAN DIEGO, CA 92107-2907
(619) 306-0811
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
01/14/2022
Last updated
01/14/2022
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