Provider Demographics
NPI:1780901835
Name:FILIZETTI, KIRSTIN GENETTE (PHD)
Entity type:Individual
Prefix:DR
First Name:KIRSTIN
Middle Name:GENETTE
Last Name:FILIZETTI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:KIRSTIN
Other - Middle Name:GENETTE
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7710 BALBOA AVE
Mailing Address - Street 2:SUITE 228
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-2261
Mailing Address - Country:US
Mailing Address - Phone:619-940-7774
Mailing Address - Fax:619-377-6701
Practice Address - Street 1:7710 BALBOA AVE
Practice Address - Street 2:SUITE 228
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-2261
Practice Address - Country:US
Practice Address - Phone:619-940-7774
Practice Address - Fax:619-377-6701
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-29
Last Update Date:2012-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY25099103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical