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Individual

AMANDA JAYNE BORLENGHI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSY.D

Contact information

Practice address
328 ENCINITAS BLVD, SUITE 100, ENCINITAS, CA 92024-8704
(760) 730-4540
(619) 528-4625
Mailing address
PO BOX 609001, SAN DIEGO, CA 92160-9001
(619) 528-4600
(619) 528-4625

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
PSB36191
CA
103TC0700X
Clinical Psychologist
Primary
PSY25760
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
W416
MEDICARE NUMBER
CA
Enumeration date
10/11/2011
Last updated
07/13/2015
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