Individual
JEFFRY CLARY WARREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1224 PROSPECT ST STE 100, LA JOLLA, CA 92037-3609
(858) 454-0576
Mailing address
1224 PROSPECT ST STE 100, LA JOLLA, CA 92037-3609
(858) 454-0576
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
5689
CA
Other
Enumeration date
08/03/2020
Last updated
08/03/2020
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