Individual
JONATHAN PATRICK DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
11201 BENTON ST, LOMA LINDA, CA 92357-1000
(909) 825-7084
Mailing address
20335 DAMIETTA DR, WALNUT, CA 91789-3723
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
103TC0700X
Clinical Psychologist
35378
CA
103TH0004X
Health Psychologist
—
—
Other
Enumeration date
06/25/2024
Last updated
01/28/2026
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