Individual
DR. DONALD PHILLIP MCKILLOP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
2820 ADELINE ST, BERKELEY, CA 94703-2264
(510) 848-5574
(510) 339-6477
Mailing address
2820 ADELINE ST, BERKELEY, CA 94703-2264
(510) 848-5574
(510) 339-6477
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY 3041
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PSY3041
LICENSED PSYCHOLOGIST
CA
Enumeration date
10/15/2006
Last updated
07/08/2007
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