Doctor Name: | DR. NADINE HYDE LARDON |
NPI Number: | 1063468973 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSYD |
License Number: | PSY18708 |
Business Practice Address: | 3790 Via De La Valle Ste 118e Del Mar, CA - 920144248 |
Business Phone Number: | 8587750091 |
Business Fax Number: | |
Mailing Address: | 3790 Via De La Valle Ste 118e, DEL MAR |
State: | CA |
Postal Code: | 920144248 |
Phone Number: | 8587750091 |
Fax Number: | |
NPI Enumeration Date: | 05/25/2006 |
NPI Last Update Date: | 01/05/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PSY18708 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |