Provider Demographics
NPI:1790885242
Name:DENISE HAWKINSON, PH.D., PSYCHOLOGIST, INC.
Entity Type:Organization
Organization Name:DENISE HAWKINSON, PH.D., PSYCHOLOGIST, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HAWKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:619-991-6900
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY20511103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty