Individual
CHARLISE THORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
355 SANTA FE DR STE 200, ENCINITAS, CA 92024-5153
(619) 922-4553
Mailing address
355 SANTA FE DR STE 201, ENCINITAS, CA 92024-5153
(619) 922-4553
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS894025489
CA
Other
Enumeration date
03/24/2022
Last updated
03/24/2022
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