Individual
IAN P EVERALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
140 ARBOR DR, SAN DIEGO, CA 92103-2007
(619) 299-3510
Mailing address
4322 ALTAMIRANO WAY, SAN DIEGO, CA 92103-1004
(619) 497-6667
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
F5245
CA
Other
Enumeration date
12/18/2006
Last updated
07/08/2007
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