Individual
DR. DANIEL KURODA ELLEDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
7910 FROST ST STE 195, SAN DIEGO, CA 92123-2897
(858) 966-8974
Mailing address
3020 CHILDRENS WAY # MC5096, SAN DIEGO, CA 92123-4223
(858) 966-8974
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
38812
TX
103TC0700X
Clinical Psychologist
PSY35268
CA
103TC2200X
Clinical Child & Adolescent Psychologist
38812
TX
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PSY35268
CA
Other
Enumeration date
08/07/2021
Last updated
09/30/2024
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