Provider Demographics
NPI:1184179749
Name:C. NAOMI WAHLER, PHD, CLINICAL PSYCHOLOGY AND ASSESSMENT SERVICES, INC
Entity Type:Organization
Organization Name:C. NAOMI WAHLER, PHD, CLINICAL PSYCHOLOGY AND ASSESSMENT SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRESTINA
Authorized Official - Middle Name:NAOMI
Authorized Official - Last Name:WAHLER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:858-254-9986
Mailing Address - Street 1:5230 CARROLL CANYON RD STE 316
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-1781
Mailing Address - Country:US
Mailing Address - Phone:858-254-9986
Mailing Address - Fax:844-584-3546
Practice Address - Street 1:5230 CARROLL CANYON RD STE 316
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-1781
Practice Address - Country:US
Practice Address - Phone:858-254-9986
Practice Address - Fax:844-584-3546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-23
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY28017103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty