Provider Demographics
NPI:1669514238
Name:WATSON, CAROL JULIANNE (PSYD)
Entity type:Individual
Prefix:DR
First Name:CAROL
Middle Name:JULIANNE
Last Name:WATSON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 N CUYAMACA ST STE 206
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-1865
Mailing Address - Country:US
Mailing Address - Phone:619-997-9794
Mailing Address - Fax:619-401-7177
Practice Address - Street 1:900 N CUYAMACA ST STE 206
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-1865
Practice Address - Country:US
Practice Address - Phone:619-997-9794
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2009-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 17837103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical