Provider Demographics
NPI:1881818797
Name:DOAK, DAVID RYAN (MS, LMFT)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:RYAN
Last Name:DOAK
Suffix:
Gender:M
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 HIGH ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603-5109
Mailing Address - Country:US
Mailing Address - Phone:530-736-1273
Mailing Address - Fax:530-885-8416
Practice Address - Street 1:1111 HIGH ST
Practice Address - Street 2:SUITE A
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-5109
Practice Address - Country:US
Practice Address - Phone:530-736-1273
Practice Address - Fax:530-885-8416
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC#40535106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist