MEDICARE: DR. DANIEL JOHN BATIUCHOK PSY.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	23234	CA
2	103T00000X	Psychologist

General Provider Information

NPI Number	:	1790848042
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL JOHN BATIUCHOK PSY.D.

Provider Business Mailing Address
First Line	:	25 AVENIDA DE ORINDA STE 100
Second Line	:
City	:	ORINDA
State	:	CA
Zip	:	94563-2305
Country	:	US
Telephone Number	:	925-421-1807
Fax Number	:

Provider Business Practice Location Address
First Line	:	25 AVENIDA DE ORINDA STE 100
Second Line	:
City	:	ORINDA
State	:	CA
Zip	:	94563-2305
Country	:	US
Telephone Number	:	925-421-1807
Fax Number	:

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

Provider Enumeration Date	:	12/18/2006
Last Update Date	:	12/13/2021

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