Provider Demographics
NPI:1205969706
Name:DILLEY, JOSEPH BRANDON (PHD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:BRANDON
Last Name:DILLEY
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 1:229 N MAIN ST STE 2022
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-2035
Mailing Address - Country:US
Mailing Address - Phone:210-964-0921
Mailing Address - Fax:
Practice Address - Street 1:229 N MAIN ST STE 2022
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-2035
Practice Address - Country:US
Practice Address - Phone:210-964-0921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39649103TH0100X, 103TM1800X, 103TP2701X, 103TC0700X, 103TA0700X, 103TB0200X, 103TC1900X, 103TC2200X, 103TF0000X
CA22371103TP2701X, 103TA0700X, 103TC2200X, 103TE1100X, 103TF0000X
CAPSY22371103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TE1100XBehavioral Health & Social Service ProvidersPsychologistExercise & Sports
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA27-0790778OtherPROFESSIONAL TAX ID NUMBER