Provider Demographics
NPI:1275569717
Name:DONALD R JARY PHD & ASSOCIATES APC
Entity Type:Organization
Organization Name:DONALD R JARY PHD & ASSOCIATES APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:R
Authorized Official - Last Name:JARY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:858-205-5394
Mailing Address - Street 1:700 E REDLANDS BLVD # U269
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-6143
Mailing Address - Country:US
Mailing Address - Phone:858-205-5394
Mailing Address - Fax:
Practice Address - Street 1:1805 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92411-1217
Practice Address - Country:US
Practice Address - Phone:858-205-5394
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty