Provider Information for 1144668575
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PHILLIP ROSS DEMING LMFT
Sex: Male
NPI: 1144668575
Last Updated: 2013-06-07
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1144668575 | ||||||||
| Enumeration Date | 2013-06-07 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | PO BOX 355 CHULA VISTA, CA 91912-0355 United States Phone: 619-252-5221 | Fax: | ||||||||
| Primary Practice Address | 18655 BERNARDO CENTER DRIVE SAN DIEGO, CA 92127 United States Phone: 619-252-5221 | Fax: | ||||||||
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