Provider Demographics
NPI:1881864742
Name:CAGGIANO, ALAN DANA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:DANA
Last Name:CAGGIANO
Suffix:
Gender:M
Credentials:PSYD
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 291
Mailing Address - Street 2:
Mailing Address - City:FORT DICK
Mailing Address - State:CA
Mailing Address - Zip Code:95538-0291
Mailing Address - Country:US
Mailing Address - Phone:510-338-2752
Mailing Address - Fax:
Practice Address - Street 1:4212 NEVIN AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94805-2342
Practice Address - Country:US
Practice Address - Phone:510-338-2752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-06
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21255103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical