Individual
DR. LILIBETH GONZALES COSICO-BERGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
327 S IVY ST, ESCONDIDO, CA 92025-4337
(858) 220-5657
Mailing address
15715 CAMINITO GILBAR, SAN DIEGO, CA 92128-3356
(858) 220-5657
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PSY19662
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PSY 196620
—
CA
Enumeration date
01/29/2007
Last updated
07/09/2007
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