Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PSY17163 | CA |
Y | 103T00000X | Psychologist | PSY17163 | CA |
N | 103TA0700X | Adult Development & Aging Psychologist | ||
N | 103TB0200X | Cognitive & Behavioral Psychologist | ||
N | 103TE1100X | Exercise & Sports Psychologist | ||
N | 103TH0100X | Health Service | ||
N | 103TP2701X | Group Psychotherapist | ||
N | 103TR0400X | Rehabilitation Psychologist |
NPI | 1295771251 |
---|---|
Provider Name | Dr. Jeri Lyn Muse |
First Address | San Diego, CA 92103-5856 |
Second Address | San Diego, CA 92103-5856 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2006 |
Last Update Date | 21/09/2010 |