Provider Demographics
NPI:1134360860
Name:VIGLIONE, DONALD JOSEPH (PHD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:JOSEPH
Last Name:VIGLIONE
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 1:10455 POMERADO RD
Mailing Address - Street 2:313 DALEY HALL
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-1717
Mailing Address - Country:US
Mailing Address - Phone:858-635-4542
Mailing Address - Fax:
Practice Address - Street 1:10455 POMERADO RD
Practice Address - Street 2:313 DALEY HALL
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92131-1717
Practice Address - Country:US
Practice Address - Phone:858-635-4542
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-10
Last Update Date:2009-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY7929103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical