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General NPI Number Information
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NPI Number | 1255478756
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Entity Type | Individual
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Provider Name | WILLIAM EDGAR DEAL PH.D
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Gender | Male
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 34800 BOB WILSON DR NMCSD
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City | SAN DIEGO
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State | CA
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Zip | 92134-1098
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Country | US
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Telephone | 760-471-2296
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Fax |
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Provider Business Mailing Address
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Address Line | 3395 CORTE TERRAL
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City | CARLSBAD
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State | CA
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Zip | 92009-6078
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Country | US
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Telephone | 760-471-2296
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY21204
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License Number State | CA
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