Individual
MR. DAVID JON EAGLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
6719 CORAL LEAF LN, RIVERSIDE, CA 92506-6213
(951) 789-9144
(951) 789-9144
Mailing address
6719 CORAL LEAF LN, RIVERSIDE, CA 92506-6213
(951) 789-9144
(951) 789-9144
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY14978
CA
103TC2200X
Clinical Child & Adolescent Psychologist
PSY14978
CA
Other
Enumeration date
01/21/2014
Last updated
01/21/2014
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