Healthcare Provider Details

I. General information

NPI: 1063574242
Provider Name (Legal Business Name): DAVID J CAIN PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3230 WARING CT SUITE H
OCEANSIDE CA
92056-4509
US

IV. Provider business mailing address

3230 WARING CT SUITE H
OCEANSIDE CA
92056-4509
US

V. Phone/Fax

Practice location:
  • Phone: 760-726-6464
  • Fax: 760-726-6483
Mailing address:
  • Phone: 760-726-6464
  • Fax: 760-726-6483

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPSY6654
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: