Provider Demographics
NPI:1922561489
Name:DUGGAN, EDWARD STRYKER (PHD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:STRYKER
Last Name:DUGGAN
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 1:624 UNIVERSITY AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94301-2019
Mailing Address - Country:US
Mailing Address - Phone:650-325-9100
Mailing Address - Fax:
Practice Address - Street 1:624 UNIVERSITY AVE STE 201
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-2019
Practice Address - Country:US
Practice Address - Phone:650-325-9100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-11
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16768103TC2200X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent