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General NPI Number Information
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NPI Number | 1154414936
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Entity Type | Individual
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Provider Name | DAVID B WATSON PH.D.
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Gender | Male
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 06/18/2013
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Provider Practice Location Address
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Address Line | 16152 BEACH BLVD STE 166
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-3843
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Country | US
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Telephone | 714-665-7072
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Fax |
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Provider Business Mailing Address
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Address Line | 16152 BEACH BLVD STE 166
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-3843
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Country | US
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Telephone | 714-665-7072
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TA0700X
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Taxonomy Name | Adult Development & Aging Psychologist
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License Number | PSY9166
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TR0400X
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Taxonomy Name | Rehabilitation Psychologist
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License Number | PSY 9166
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License Number State | CA
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