Provider Demographics
NPI:1003545567
Name:DR DANA GIRARD CLINICAL PSYCHOLOGIST INC
Entity type:Organization
Organization Name:DR DANA GIRARD CLINICAL PSYCHOLOGIST INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANA
Authorized Official - Middle Name:MONIQUE
Authorized Official - Last Name:GIRARD
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:650-889-8765
Mailing Address - Street 1:1788 KANSAS ST
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94061-2635
Mailing Address - Country:US
Mailing Address - Phone:650-889-8765
Mailing Address - Fax:650-649-1943
Practice Address - Street 1:1788 KANSAS ST
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94061-2635
Practice Address - Country:US
Practice Address - Phone:650-889-8765
Practice Address - Fax:650-649-1943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-08
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty