Basic Information
| Provider Information | |||||||||
| NPI: | 1003806589 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VERNON | ||||||||
| FirstName: | MARGARET | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PH.E. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2231 CAMINO DEL RIO S | ||||||||
| Address2: | STE 308 | ||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921083612 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6192815521 | ||||||||
| FaxNumber: | 6192603054 | ||||||||
| Practice Location | |||||||||
| Address1: | 2231 CAMINO DEL RIO S | ||||||||
| Address2: | STE 308 | ||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921083612 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6192815521 | ||||||||
| FaxNumber: | 6192603054 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/25/2005 | ||||||||
| LastUpdateDate: | 10/18/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | PSY4659 | CA | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.