Provider Demographics
NPI:1659648533
Name:VAIL, ANTHONY FRANK (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:FRANK
Last Name:VAIL
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 1:826 CALLE TALENTIA
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-7945
Mailing Address - Country:US
Mailing Address - Phone:760-975-4991
Mailing Address - Fax:
Practice Address - Street 1:826 CALLE TALENTIA
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-7945
Practice Address - Country:US
Practice Address - Phone:760-975-4991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-21
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 4580103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical