Organization
RADY CHILDREN'S HOSPITAL OUTPATIENT PSYCHIATRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA HAZLEWOOD PH.D. (SITE COORDINATOR)
(858) 487-9050
Entity
Organization
Contact information
Practice address
625 W CITRACADO PKWY, SUITE 102, ESCONDIDO, CA 92025-6479
(760) 294-9270
(760) 294-9268
Mailing address
625 W CITRACADO PKWY, SUITE 102, ESCONDIDO, CA 92025-6479
(760) 294-9270
(760) 294-9268
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
MFC 31074
CA
Other
Enumeration date
03/19/2007
Last updated
08/22/2020
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