Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mark L Ettenhofer, PHD

Individual provider Clinical Neuropsychologist · NPI 1922480755

Mark L Ettenhofer, PHD is a Clinical Neuropsychologist in San Diego, California. Licensed in Maryland. Registered with an NPI since 2015.

Licensed in
MD
In the registry since
2015
Specialties on file
2
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

34800 Bob Wilson Dr
San Diego, CA 92134-1098
Phone: (301) 678-3321
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence 04643 (MD)
Clinical Neuropsychologist Taxonomy 103G00000X · Licence 04643 (MD)

Record details

NPI number1922480755
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD
Sole proprietorNo
NPI enumeratedJune 29, 2015
Last updated in NPPESMarch 15, 2024
Certification dateMarch 15, 2024

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