Provider Demographics
NPI:1912398215
Name:WESTFALL, DORIBETH
Entity Type:Individual
Prefix:MRS
First Name:DORIBETH
Middle Name:
Last Name:WESTFALL
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:DORIBETH
Other - Middle Name:
Other - Last Name:WESTFALL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:3350 LA JOLLA VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92161-0002
Mailing Address - Country:US
Mailing Address - Phone:858-642-1011
Mailing Address - Fax:
Practice Address - Street 1:3500 LA JOLLA VILLAGE DR
Practice Address - Street 2:MAIL CODE 122
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92161-4573
Practice Address - Country:US
Practice Address - Phone:858-642-1011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-09
Last Update Date:2015-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00011091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical