Individual
DAVID L. GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1101 B GALE WILSON BLVD STE 307, FAIRFIELD, CA 94533-3702
(707) 428-3435
(707) 428-3770
Mailing address
2685 LESLIE RD, SANTA ROSA, CA 95404-9607
(707) 575-5355
(707) 575-1491
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY 9264
CA
Other
Enumeration date
10/24/2006
Last updated
07/08/2007
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