Provider Demographics
NPI:1265690143
Name:DOWLING, VICKIE LYNN (PSYD)
Entity Type:Individual
Prefix:
First Name:VICKIE
Middle Name:LYNN
Last Name:DOWLING
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:PO BOX 2441
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92018-2441
Mailing Address - Country:US
Mailing Address - Phone:858-361-4002
Mailing Address - Fax:760-720-3739
Practice Address - Street 1:2945 HARDING ST STE 109
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-1818
Practice Address - Country:US
Practice Address - Phone:858-361-4002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-28
Last Update Date:2023-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X
CAPSY21983103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW416Medicare PIN