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General NPI Number Information
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NPI Number | 1295453181
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Entity Type | Organization
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Legal Business Name | THOMAS MCDONAGH
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Dates
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Enumeration Date | 08/17/2022
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Last Update Date | 01/02/2024
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Provider Practice Location Address
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Address Line | 870 MARKET ST STE 617
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City | SAN FRANCISCO
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State | CA
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Zip | 94102-3014
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Country | US
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Telephone | 415-483-0950
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Fax |
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Provider Business Mailing Address
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Address Line | 870 MARKET ST STE 617
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City | SAN FRANCISCO
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State | CA
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Zip | 94102-3014
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Country | US
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Telephone | 415-483-0950
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. THOMAS MATTHEW MCDONAGH
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Credential | PSY.D.
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Telephone | 415-483-0950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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