Provider Demographics
NPI:1154964567
Name:RODGER STACY QUESTIN, PSYCHOLOGIST P.C.
Entity type:Organization
Organization Name:RODGER STACY QUESTIN, PSYCHOLOGIST P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RODGER
Authorized Official - Middle Name:STACY
Authorized Official - Last Name:QUESTIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:310-351-6113
Mailing Address - Street 1:440 UPAS ST APT 402
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-4919
Mailing Address - Country:US
Mailing Address - Phone:310-351-6113
Mailing Address - Fax:
Practice Address - Street 1:440 UPAS ST APT 402
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103
Practice Address - Country:US
Practice Address - Phone:310-351-6113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-18
Last Update Date:2019-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty