Healthcare Provider Details

I. General information

NPI: 1144381898
Provider Name (Legal Business Name): DAVID PAUL HATHERILL PHD LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: DR. DAVID HATHERILL

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2120 THIBODO CT SUITE 230
VISTA CA
92085
US

IV. Provider business mailing address

P O BOX 867
DEL MAR CA
92014-0867
US

V. Phone/Fax

Practice location:
  • Phone: 858-279-1223
  • Fax: 760-597-4880
Mailing address:
  • Phone: 619-772-3283
  • Fax: 858-523-1442

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC 17362
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number4101006345
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: