Provider Demographics
NPI:1609975515
Name:KREGER, DON W (PHD)
Entity Type:Individual
Prefix:DR
First Name:DON
Middle Name:W
Last Name:KREGER
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:PO BOX 1308
Mailing Address - Street 2:
Mailing Address - City:LITTLEROCK
Mailing Address - State:CA
Mailing Address - Zip Code:93543-5308
Mailing Address - Country:US
Mailing Address - Phone:661-944-2850
Mailing Address - Fax:
Practice Address - Street 1:16195 SISKIYOU RD
Practice Address - Street 2:SUITE 120-A
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-1346
Practice Address - Country:US
Practice Address - Phone:760-946-2070
Practice Address - Fax:760-946-1511
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY17261103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist