Provider Demographics
NPI:1629424783
Name:KIRSTIN FILIZETTI, PHD
Entity Type:Organization
Organization Name:KIRSTIN FILIZETTI, PHD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KIRSTIN
Authorized Official - Middle Name:GENETTE
Authorized Official - Last Name:FILIZETTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-940-7774
Mailing Address - Street 1:2535 CAMINO DEL RIO SOUTH
Mailing Address - Street 2:SUITE 106
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108
Mailing Address - Country:US
Mailing Address - Phone:619-940-7774
Mailing Address - Fax:619-377-6701
Practice Address - Street 1:2535 CAMINO DEL RIO SOUTH
Practice Address - Street 2:SUITE 106
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108
Practice Address - Country:US
Practice Address - Phone:619-940-7774
Practice Address - Fax:619-377-6701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-09
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF67622101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty