Individual
DR. JUDITH SANDRA DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1800 MEDICAL CENTER DRIVE, SUITE 300, SAN BERNARDINO, CA 92411
(909) 887-6222
(909) 887-4565
Mailing address
11083 TWILIGHT WAY, MORENO VALLEY, CA 92555-6594
(951) 242-8867
(951) 242-8867
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY17053
CA
Other
Enumeration date
10/29/2007
Last updated
10/29/2007
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