Individual
ERYNN ELIZABETH MACCIOMEI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3760 CONVOY ST STE 118, SAN DIEGO, CA 92111-3743
(586) 634-4644
Mailing address
4449 TEMECULA ST, SAN DIEGO, CA 92107-1003
(586) 634-4464
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY30421
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PSY30421
STATE OF CA
CA
Enumeration date
10/24/2020
Last updated
10/24/2020
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