Provider Demographics
NPI:1952399289
Name:DANTON, WILLIAM GORDON (PHD)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:GORDON
Last Name:DANTON
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 1:200 MEADOW EDGE CT
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-8722
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6490 S MCCARRAN BLVD
Practice Address - Street 2:BLDG. D1, STE. 28
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-6102
Practice Address - Country:US
Practice Address - Phone:775-826-6218
Practice Address - Fax:775-826-6271
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-11
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPSY 054103TC0700X
CAPL 4851103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002616004Medicaid