Provider Demographics
NPI:1225056419
Name:GALLO, DONALD PHILIP (PHD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:PHILIP
Last Name:GALLO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21241 VENTURA BLVD
Mailing Address - Street 2:SUITE 180
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-2108
Mailing Address - Country:US
Mailing Address - Phone:818-472-2029
Mailing Address - Fax:
Practice Address - Street 1:21241 VENTURA BLVD
Practice Address - Street 2:SUITE 180
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-2108
Practice Address - Country:US
Practice Address - Phone:818-472-2029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY16889103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent