Provider Demographics
NPI:1275688939
Name:DOWNIE, PAMELA (PHD)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:
Last Name:DOWNIE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17494 SANTA ROSA MINE RD
Mailing Address - Street 2:
Mailing Address - City:PERRIS
Mailing Address - State:CA
Mailing Address - Zip Code:92570-7758
Mailing Address - Country:US
Mailing Address - Phone:951-940-5802
Mailing Address - Fax:951-443-1139
Practice Address - Street 1:370 W GRAND BLVD
Practice Address - Street 2:SUITE 106
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-2173
Practice Address - Country:US
Practice Address - Phone:951-940-5802
Practice Address - Fax:951-443-1139
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 18287103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA33BEFNMedicaid
CA33BEFNMedicaid