Provider Demographics
NPI:1851431977
Name:HELLWIG, DAVID LINDLEY (PHD)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:LINDLEY
Last Name:HELLWIG
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 1:1357 W SHAW AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-3618
Mailing Address - Country:US
Mailing Address - Phone:559-227-4800
Mailing Address - Fax:559-222-3939
Practice Address - Street 1:1357 W SHAW AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-3618
Practice Address - Country:US
Practice Address - Phone:559-227-4800
Practice Address - Fax:559-222-3939
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY14566103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACI920AOtherMEDICARE PTAN