Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY6418 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY6418 | CA |
NPI | 1013024744 |
---|---|
Provider Name | Dr. David Waring Debus |
First Address | San Diego, CA 92131-1705 |
Second Address | San Diego, CA 92123-1578 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2006 |
Last Update Date | 07/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
PSN6418 | (02) | |
PSY6418 | (05) | CA |