Provider Demographics
NPI:1306005566
Name:MASSON, NATALIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:
Last Name:MASSON
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 1:8950 VILLA LA JOLLA DR STE A218
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1711
Mailing Address - Country:US
Mailing Address - Phone:858-453-2505
Mailing Address - Fax:925-226-4843
Practice Address - Street 1:8950 VILLA LA JOLLA DR STE A218
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1711
Practice Address - Country:US
Practice Address - Phone:858-453-2505
Practice Address - Fax:925-226-4843
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY17895103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical