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Contact Information

JACQUELINE M GAMBOA, PSY.D.
12625 HIGH BLUFF DR
SUITE 114
SAN DIEGO, CA92130-2052
 Phone: 858-492-8445
 Fax: 858-492-8445
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
 

Addiction (Substance Use Disorder)

103TA0400X 62 Psychologist, Clinical
 

Clinical Child & Adolescent

103TC2200X 62 Psychologist, Clinical
 

Family

103TF0000X 62 Psychologist, Clinical
 

Intellectual & Developmental Disabilities

103TM1800X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for JACQUELINE M GAMBOA · (Female)

NPI Number 1083948046
Status Active
Credentials PSY.D. (Doctor of Psychology)
Entity Individual
Enumeration date 09/23/2009
Last updated 06/03/2010 - About 16 years ago
Sole proprietor 1 Yes
Identifiers
  • CA License # PSY22784
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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