MEDICARE: DR. DAVID MICHAEL GREEN PH.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PSY4696	CA
2	103TF0200X	Forensic Psychologist	PSY4696	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457417685
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID MICHAEL GREEN PH.D

Provider Business Mailing Address
First Line	:	5333 MISSION CENTER RD
Second Line	:	SUITE 354
City	:	SAN DIEGO
State	:	CA
Zip	:	92108
Country	:	US
Telephone Number	:	619-281-0616
Fax Number	:	619-528-1263

Provider Business Practice Location Address
First Line	:	3549 CAMINO DEL RIO S
Second Line	:	SUITE D
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-4023
Country	:	US
Telephone Number	:	619-281-0616
Fax Number	:	619-528-1263

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/30/2006
Last Update Date	:	09/11/2025

Similar Medicare Providers

1861428104 — MR. KAYVAN BINAEI PA
Practice Location Address:

3549 CAMINO DEL RIO S , SUITE A
SAN DIEGO, CA
92108-4023

Practice Phone: 619-543-0144
Practice Fax: 619-543-0445

1598078982 — SARAH BALDWIN LMFT
Practice Location Address:

6070 MISSION GORGE RD
SAN DIEGO, CA
92120-4023

Practice Phone: 619-909-9169
Practice Fax:

1720536147 — DA JUNG ALBUS SLP
Practice Location Address:

3570 LOUISIANA ST
SAN DIEGO, CA
92104-4023

Practice Phone: 989-506-6598
Practice Fax:

1134608045 — CHANTEL ENRIQUEZ MA
Practice Location Address:

6070 MISSION GORGE RD
SAN DIEGO, CA
92120-4023

Practice Phone: 619-961-7734
Practice Fax:

1003472226 — VISTA HILL FOUNDATION
Practice Location Address:

6070 MISSION GORGE RD
SAN DIEGO, CA
92120-4023

Practice Phone: 619-957-0888
Practice Fax:

1699325381 — CANDI FUNES
Practice Location Address:

6070 MISSION GORGE RD
SAN DIEGO, CA
92120-4023

Practice Phone: 619-333-4250
Practice Fax:

Directions to “ DR. DAVID MICHAEL GREEN PH.D” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.