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Individual

CORNELIA CARLTON PENN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
425 N DATE ST, ESCONDIDO, CA 92025-3413
(760) 746-5857
(760) 746-2361
Mailing address
425 N DATE ST, ESCONDIDO, CA 92025-3413
(760) 737-2035
(760) 741-2782

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY 14310
CA

Other

Enumeration date
07/11/2006
Last updated
07/08/2007
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