Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | PSY7427 | CA |
N | 103G00000X | Clinical Psychologist | PSY7427 | CA |
N | 103TC0700X | Clinical Psychologist | PSY7427 | CA |
NPI | 1194949370 |
---|---|
Provider Name | Dr. Catherine Fitzsimons Jervey |
First Address | La Mesa, CA 91941-3900 |
Second Address | San Diego, CA 92110-5001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2007 |
Last Update Date | 08/07/2007 |