Healthcare Provider Details

I. General information

NPI: 1497822837
Provider Name (Legal Business Name): DAVID DANIEL STEIN PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2456 BUSH ST
SAN FRANCISCO CA
94115-3106
US

IV. Provider business mailing address

2456 BUSH ST
SAN FRANCISCO CA
94115-3106
US

V. Phone/Fax

Practice location:
  • Phone: 415-923-1365
  • Fax: 415-567-6309
Mailing address:
  • Phone: 415-923-1365
  • Fax: 415-567-6309

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY 4238
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: