Provider Demographics
NPI:1720274517
Name:PRESBY, DAVID
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:PRESBY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 NORTH CORDOVA STREET
Mailing Address - Street 2:APT D
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505
Mailing Address - Country:US
Mailing Address - Phone:323-493-4918
Mailing Address - Fax:
Practice Address - Street 1:235 NORTH CORDOVA STREET
Practice Address - Street 2:APT D
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505
Practice Address - Country:US
Practice Address - Phone:323-493-4918
Practice Address - Fax:562-490-7682
Is Sole Proprietor?:No
Enumeration Date:2007-09-14
Last Update Date:2021-12-22
Deactivation Date:2018-07-26
Deactivation Code:
Reactivation Date:2018-10-23
Provider Licenses
StateLicense IDTaxonomies
CAMFC46919106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist