Polson, Dorian L

Polson, Dorian L is an individual health care provider with primary practice located at 3760 Convoy St Ste 118, San Diego CA 92111-3742. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Polson, Dorian L can be contacted via phone (858) 268-4082.

Contact Information

Primary practice address
3760 Convoy St Ste 118 San Diego CA 92111-3742
Phone: (858) 268-4082
Fax: (858) 292-0143
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY8656 California

Profile Details

NPI number 1437159001
LBN Legal business name Polson, Dorian L
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 26th, 2005
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437159001 NPPES
California MEDICAID PSY086560

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