Individual
DR. ANN KATHRYN CARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
9261 FULLERTON AVE, SAN DIEGO, CA 92123-3146
(619) 516-0221
(858) 496-9782
Mailing address
9261 FULLERTON AVE, SAN DIEGO, CA 92123-3146
(619) 516-0221
(858) 496-9782
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY12884
CA
163W00000X
Registered Nurse
R213694
CA
363L00000X
Nurse Practitioner
1477
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
183091
MANAGED HEALTH NETWORK
CA
01
—
330490987 92108 A001
TRICARE
CA
01
—
OPL128840
BLUE SHIELD
CA
05
—
PSY128840
—
CA
Enumeration date
05/12/2006
Last updated
10/07/2016
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