Individual
MRS. GINIENA TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LEP, PPS
Contact information
Practice address
2235 ENCINITAS BLVD STE 108, ENCINITAS, CA 92024-4356
(760) 704-8345
Mailing address
2235 ENCINITAS BLVD. STE. 108, ENCINITAS, CA 92024
(858) 245-0704
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
4046
CA
103TS0200X
School Psychologist
—
CA
Other
Enumeration date
06/12/2023
Last updated
07/17/2023
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