Individual
RYAN GAVIN DUNNIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3270 KERNER BLVD STE A, SAN RAFAEL, CA 94901-4840
(415) 473-2681
(415) 473-5850
Mailing address
183 KNOLLWOOD DR, SAN RAFAEL, CA 94901-1518
(415) 720-2663
Taxonomy
Speciality
Code
Description
License number
State
103TF0200X
Forensic Psychologist
Primary
PSY27458
CA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
09/02/2010
Last updated
09/03/2015
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