Provider Demographics
NPI:1043345622
Name:CROWLE, GERALDINE MARIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:GERALDINE
Middle Name:MARIE
Last Name:CROWLE
Suffix:
Gender:F
Credentials:PHD
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Mailing Address - Street 1:823 GATEWAY CENTER WAY
Mailing Address - Street 2:BEHAVIORAL HEALTH OUTPATIENT - LEVEL D
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92102-4541
Mailing Address - Country:US
Mailing Address - Phone:619-906-4623
Mailing Address - Fax:619-906-4564
Practice Address - Street 1:4077 5TH AVE
Practice Address - Street 2:BEHAVIORAL HEALTH OUTPATIENT - LEVEL D
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2105
Practice Address - Country:US
Practice Address - Phone:619-260-7066
Practice Address - Fax:619-260-7219
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPSY13902103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical