Provider Demographics
NPI:1669684775
Name:CORRINGTON, SALLY ANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:SALLY
Middle Name:ANN
Last Name:CORRINGTON
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 1:620 VIA BOGOTA
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92081-6349
Mailing Address - Country:US
Mailing Address - Phone:760-630-1078
Mailing Address - Fax:760-758-4039
Practice Address - Street 1:620 VIA BOGOTA
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92081-6349
Practice Address - Country:US
Practice Address - Phone:760-630-1078
Practice Address - Fax:760-758-4039
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY5415103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical