Whitehead, Dan
Whitehead, Dan is an sole proprietor health care provider with primary practice located at 2515 Camino Del Rio S Suite 114, San Diego CA 92108-3792. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Neuropsychologist, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Forensic. Behavioral Health & Social Service Providers / Clinical Neuropsychologist is his primary health care specialty. Whitehead, Dan can be contacted via phone (619) 518-2051.Contact Information
Primary practice address
2515 Camino Del Rio S Suite 114
San Diego CA 92108-3792
Phone: (619) 518-2051
Fax: (619) 518-2051
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical Neuropsychologist | 103G00000X | PSY13833 | California |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | PSY13833 | California |
| Behavioral Health & Social Service Providers / Forensic | 103TF0200X | PSY13833 | California |
Profile Details
| NPI number | 1952394033 |
|---|---|
| LBN Legal business name | Whitehead, Dan |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 24th, 2005 |
| Last updated | Apr 28th, 2009 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1952394033 | NPPES |
| California | MEDICAID | PSY138330 |
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