Provider Demographics
NPI:1104023019
Name:WARFIELD, MICHELLE (PHD)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:
Last Name:WARFIELD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:WARFIELD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:1991 VILLAGE PARK WAY STE 100
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-1966
Mailing Address - Country:US
Mailing Address - Phone:303-929-8269
Mailing Address - Fax:
Practice Address - Street 1:1991 VILLAGE PARK WAY STE 100
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-1966
Practice Address - Country:US
Practice Address - Phone:303-929-8269
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-03
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY24877103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist