Provider Demographics
NPI:1023031564
Name:CHRISTIAN, DARRELL RAY (PHD)
Entity Type:Individual
Prefix:DR
First Name:DARRELL
Middle Name:RAY
Last Name:CHRISTIAN
Suffix:
Gender:M
Credentials:PHD
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Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2950 CAMINO DIABLO
Mailing Address - Street 2:SUITE 120
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94597-3978
Mailing Address - Country:US
Mailing Address - Phone:925-935-8646
Mailing Address - Fax:925-935-8646
Practice Address - Street 1:2950 CAMINO DIABLO
Practice Address - Street 2:SUITE 120
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94597-3978
Practice Address - Country:US
Practice Address - Phone:925-935-8646
Practice Address - Fax:925-935-8646
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPSY11699103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist