Provider Demographics
NPI:1063404614
Name:TANSEY, DAVID ARTHUR (PHD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ARTHUR
Last Name:TANSEY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 910094
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92191-0094
Mailing Address - Country:US
Mailing Address - Phone:858-481-9164
Mailing Address - Fax:858-481-1004
Practice Address - Street 1:5520 WELLESLEY ST
Practice Address - Street 2:SUITE 107
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-4431
Practice Address - Country:US
Practice Address - Phone:858-481-9164
Practice Address - Fax:858-481-1004
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-19
Last Update Date:2014-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 5081103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00PL50810OtherBC/BS
CA00PL50810Medicaid
CA00PL50810Medicaid