Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TC2200X | Clinical Child & Adolescent Psychologist |
NPI | 1063733707 |
---|---|
Provider Name | Kristen J Peairs |
First Address | San Diego, CA 92103-2809 |
Second Address | San Diego, CA 92103-2809 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2010 |
Last Update Date | 18/03/2011 |