Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY4659 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY4659 | CA |
NPI | 1003806589 |
---|---|
Provider Name | Dr. Margaret Vernon |
First Address | San Diego, CA 92108-3612 |
Second Address | San Diego, CA 92108-3612 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2005 |
Last Update Date | 18/10/2011 |