Provider Demographics
NPI:1427148733
Name:LAWRENCE, MEG DEPENDER (MD)
Entity type:Individual
Prefix:DR
First Name:MEG
Middle Name:DEPENDER
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARGARET
Other - Middle Name:CATHERINE
Other - Last Name:DEPENDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3754 CLAIREMONT DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-5916
Mailing Address - Country:US
Mailing Address - Phone:858-581-5050
Mailing Address - Fax:858-483-3567
Practice Address - Street 1:3754 CLAIREMONT DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117-5916
Practice Address - Country:US
Practice Address - Phone:858-581-5050
Practice Address - Fax:858-483-3567
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-15
Last Update Date:2014-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC50118208000000X, 2084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry