Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY 19014 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY 19014 | CA |
N | 102L00000X | Psychologist | PSY 19014 | CA |
N | 103T00000X | Psychologist | PSY 19014 | CA |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | PSY 19014 | CA |
N | 103TA0700X | Adult Development & Aging Psychologist | PSY 19014 | CA |
N | 103TB0200X | Cognitive & Behavioral Psychologist | PSY 19014 | CA |
N | 103G00000X | Clinical Psychologist | PSY 19014 | CA |
N | 103TC0700X | Clinical Psychologist | PSY 19014 | CA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | PSY 19014 | CA |
N | 103TF0000X | Family Psychologist | PSY 19014 | CA |
N | 103TF0200X | Forensic Psychologist | PSY 19014 | CA |
N | 103TR0400X | Rehabilitation Psychologist | PSY 19014 | CA |
NPI | 1124141031 |
---|---|
Provider Name | Dr. David Frederick Dahl |
First Address | Campbell, CA 95008-5565 |
Second Address | Campbell, CA 95008-5565 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2007 |
Last Update Date | 12/04/2016 |