Provider Demographics
NPI:1629515002
Name:SLIMOWICZ, JOSEPH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:SLIMOWICZ
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 1:3023 BUNKER HILL ST STE 102-3
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92109-5706
Mailing Address - Country:US
Mailing Address - Phone:619-942-5515
Mailing Address - Fax:619-942-5517
Practice Address - Street 1:3023 BUNKER HILL ST STE 102-3
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92109-5706
Practice Address - Country:US
Practice Address - Phone:619-942-5515
Practice Address - Fax:619-942-5517
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-24
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY29414103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist