Provider Demographics
NPI:1881658235
Name:HAHN, DAVID T (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:T
Last Name:HAHN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1252 BROADWAY
Mailing Address - Street 2:STE I
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92021-4904
Mailing Address - Country:US
Mailing Address - Phone:619-209-6040
Mailing Address - Fax:866-273-2035
Practice Address - Street 1:8880 RIO SAN DIEGO DR
Practice Address - Street 2:#800
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-1634
Practice Address - Country:US
Practice Address - Phone:619-209-6040
Practice Address - Fax:866-273-2035
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-13
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPSY19168103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA300929OtherMHN
CA0PL191682OtherBLUE SHIELD
CA7572336Medicaid
CA2937336Medicaid
CA0PL191680OtherBLUE SHIELD
CA0PL191682OtherBLUE SHIELD
CA7572336Medicaid