Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PSY15234 | CA |
Y | 103T00000X | Psychologist | PSY15234 | CA |
N | 103TB0200X | Cognitive & Behavioral Psychologist | PSY15234 | CA |
N | 103TC1900X | Counseling Psychologist | PSY15234 | CA |
NPI | 1093721912 |
---|---|
Provider Name | Dr. David Lawrence Astle |
First Address | Irvine, CA 92604-4767 |
Second Address | Irvine, CA 92604-1726 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2006 |
Last Update Date | 21/02/2020 |