Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | PSY25050 | CA |
N | 103TB0200X | Cognitive & Behavioral Psychologist | PSY25050 | CA |
Y | 103G00000X | Clinical Psychologist | PSY25050 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY25050 | CA |
NPI | 1164780714 |
---|---|
Provider Name | Dr. Regina Lynn Huelsenbeck |
First Address | Encinitas, CA 92024-3568 |
Second Address | Encinitas, CA 92024-3568 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2012 |
Last Update Date | 10/06/2021 |