Provider Demographics
NPI:1104251719
Name:FRANKEL, DAVID JAY (PHD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JAY
Last Name:FRANKEL
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 1:2 FIFER AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CORTE MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:94925-1134
Mailing Address - Country:US
Mailing Address - Phone:415-927-7067
Mailing Address - Fax:415-927-2179
Practice Address - Street 1:2 FIFER AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:CORTE MADERA
Practice Address - State:CA
Practice Address - Zip Code:94925-1134
Practice Address - Country:US
Practice Address - Phone:415-927-7067
Practice Address - Fax:415-927-2179
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-13
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY13682103TC0700X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent