Provider Demographics
NPI:1780792424
Name:CHRISTIANO, DANIEL JOSEPH JR (PHD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JOSEPH
Last Name:CHRISTIANO
Suffix:JR
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4115 E VALLEY AUTO DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-4606
Mailing Address - Country:US
Mailing Address - Phone:480-507-7880
Mailing Address - Fax:480-507-7880
Practice Address - Street 1:4115 E VALLEY AUTO DR
Practice Address - Street 2:SUITE 203
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-4606
Practice Address - Country:US
Practice Address - Phone:480-507-7880
Practice Address - Fax:480-507-7880
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ0958103T00000X, 103TC2200X
103TA0700X, 103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic