Provider Demographics
NPI:1649812363
Name:PAULUS, THOMAS BROOKS (PSYD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:BROOKS
Last Name:PAULUS
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 1:253 DELPHINIUM ST
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-3304
Mailing Address - Country:US
Mailing Address - Phone:540-761-3404
Mailing Address - Fax:
Practice Address - Street 1:169 SAXONY RD STE 205
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-6780
Practice Address - Country:US
Practice Address - Phone:540-761-3404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-15
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY30755103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical