Provider Demographics
NPI:1093933707
Name:HSIEH, PAULINE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:PAULINE
Middle Name:
Last Name:HSIEH
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12396 WORLD TRADE DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-3786
Mailing Address - Country:US
Mailing Address - Phone:858-224-2255
Mailing Address - Fax:
Practice Address - Street 1:12396 WORLD TRADE DR
Practice Address - Street 2:SUITE 105
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-3786
Practice Address - Country:US
Practice Address - Phone:858-224-2255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY23378103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical