Provider Demographics
NPI:1447419775
Name:PANDO, JOSEPH IGNACIO (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:IGNACIO
Last Name:PANDO
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8765 AERO DR
Mailing Address - Street 2:SUITE 221
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1781
Mailing Address - Country:US
Mailing Address - Phone:831-596-6817
Mailing Address - Fax:
Practice Address - Street 1:8765 AERO DR
Practice Address - Street 2:SUITE 221
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1781
Practice Address - Country:US
Practice Address - Phone:831-596-6817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-02
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27338103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical