Individual
DR. JONATHAN DATOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
9500 GILMAN DR, LA JOLLA, CA 92093-5004
(203) 512-8428
Mailing address
9500 GILMAN DR, LA JOLLA, CA 92093-5004
(203) 512-8428
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
7598745987498
CA
Other
Enumeration date
11/03/2014
Last updated
11/03/2014
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