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General NPI Number Information
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NPI Number | 1942447909
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Entity Type | Individual
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Provider Name | JULIE ANN DAGGETT PH.D.
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Gender | Female
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Dates
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Enumeration Date | 01/13/2009
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Last Update Date | 01/13/2009
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Provider Practice Location Address
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Address Line | 1411 MARSH ST STE. 104
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-2957
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Country | US
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Telephone | 805-547-1720
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Fax | 805-547-1720
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Provider Business Mailing Address
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Address Line | 1411 MARSH ST STE. 104
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-2957
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Country | US
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Telephone | 805-547-1720
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Fax | 805-547-1720
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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 | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | PSY18057
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | PSY18057
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License Number State | CA
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