Provider Demographics
NPI:1275699332
Name:DOVE, ELAINE JOYCE (PYSD)
Entity Type:Individual
Prefix:DR
First Name:ELAINE
Middle Name:JOYCE
Last Name:DOVE
Suffix:
Gender:F
Credentials:PYSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8889 CAMINITO PLAZA CENTRO UNIT 7215
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92122-1098
Mailing Address - Country:US
Mailing Address - Phone:858-401-2449
Mailing Address - Fax:
Practice Address - Street 1:7590 FAY AVE
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-4885
Practice Address - Country:US
Practice Address - Phone:858-401-2449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACAPSY14065103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist