Individual
DR. GORDON LUCA RENWICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D
Contact information
Practice address
900 N CUYAMACA ST, SUITE 206, EL CAJON, CA 92020-1865
(619) 218-9181
Mailing address
4825 UTAH ST, SAN DIEGO, CA 92116-1426
(619) 284-6985
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY 16183
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PSY16183
—
CA
Enumeration date
08/03/2006
Last updated
07/09/2007
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