Provider Demographics
NPI:1558462705
Name:HAWKINSON, DENISE LYNN (PHD)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:LYNN
Last Name:HAWKINSON
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 1:5980 CAMINO DE LA COSTA
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-6550
Mailing Address - Country:US
Mailing Address - Phone:858-459-6833
Mailing Address - Fax:
Practice Address - Street 1:4225 EXECUTIVE SQ
Practice Address - Street 2:#1110
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-9122
Practice Address - Country:US
Practice Address - Phone:858-558-8535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY20511103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical