Provider Demographics
NPI:1740485259
Name:MCCANN, MATTHEW NEIL (PHD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:NEIL
Last Name:MCCANN
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 1:3333 S BREA CANYON RD
Mailing Address - Street 2:SUITE 218
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-3786
Mailing Address - Country:US
Mailing Address - Phone:909-598-7422
Mailing Address - Fax:
Practice Address - Street 1:3333 S BREA CANYON RD
Practice Address - Street 2:SUITE 218
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91765-3786
Practice Address - Country:US
Practice Address - Phone:909-598-7422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 27354106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist