Provider Demographics
NPI:1427852078
Name:LURIE, DAPHNE (PHD)
Entity type:Individual
Prefix:DR
First Name:DAPHNE
Middle Name:
Last Name:LURIE
Suffix:
Gender:
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12468 CARMEL POINTE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-2268
Mailing Address - Country:US
Mailing Address - Phone:858-926-9028
Mailing Address - Fax:858-777-9609
Practice Address - Street 1:12526 HIGH BLUFF DR STE 300
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-2067
Practice Address - Country:US
Practice Address - Phone:858-925-9028
Practice Address - Fax:858-777-9609
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY-22195103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical