Individual
DR. BRUCE L. THIESSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
8360 UNIVERSITY AVE, LA MESA, CA 91942-9374
(619) 713-2622
Mailing address
8360 UNIVERSITY AVE, LA MESA, CA 91942-9374
(619) 713-2622
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY14259
CA
Other
Enumeration date
09/28/2012
Last updated
09/28/2012
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