MARK L ETTENHOFER PHD
NPI 1922480755
Psychologist - Clinical in San Diego, CA

Q: What is Mark Ettenhofer's NPI number?

The NPI number for Mark Ettenhofer is 1922480755. It was assigned to this individual provider in the NPPES registry on June 29, 2015.

Q: What is Mark Ettenhofer's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: When was this NPI record last updated?

The NPPES record for Mark Ettenhofer was last updated on March 15, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 29, 2015

34800 BOB WILSON DR, SAN DIEGO, CA 92134(301) 678-3321 Get Directions Write a Review

NPPES record last updated: March 15, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Mark L Ettenhofer Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARK L ETTENHOFER PHD (NPI 1922480755) is an individual clinical provider in San Diego, California, licensed in Maryland (04643) and active in the NPI registry since June 2015.

NPPES Registry Identity

NPI1922480755

Entity TypeIndividualMale

Primary Taxonomy103TC0700X

Provider Legal NameMARK L ETTENHOFERCredential: PHD

Location Address34800 BOB WILSON DRSan Diego, CA 92134-1098

Mailing Address34800 Bob Wilson DrSan Diego, CA 92134-1098

Phone(301) 678-3321

Sole ProprietorNo

Enumeration DateJune 29, 2015

Last NPPES UpdateMarch 15, 2024

NPPES CertifiedMarch 15, 2024

✔ NPI 1922480755 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in MD · 04643

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

Also ListedClinical NeuropsychologistTaxonomy 103G00000X · License 04643 (MD)

34800 BOB WILSON DR, San Diego, CA 92134

Open in Google Maps ↗

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LORENA MARIE FUJII N.P.

Nurse Practitioner (Pediatrics)