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General NPI Number Information
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NPI Number | 1780689703
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Entity Type | Individual
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Provider Name | GEORGE H DASKALOS PH.D.
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Gender | Male
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Dates
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Enumeration Date | 06/16/2005
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Last Update Date | 09/16/2024
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Provider Practice Location Address
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Address Line | 1301 UNION DR
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City | DAVIS
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State | CA
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Zip | 95616-1341
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Country | US
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Telephone | 530-400-8446
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Fax | 530-756-3256
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Provider Business Mailing Address
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Address Line | PO BOX 104 DAVIS P.O. 2020 5TH ST
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City | DAVIS
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State | CA
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Zip | 95617-0104
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Country | US
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Telephone | 530-400-8446
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Fax | 530-758-0661
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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 | PSY15400
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License Number State | CA
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