Individual
DR. DANIEL MICHAEL BLONIGEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
795 WILLOW RD, MPD-152, MENLO PARK, CA 94025-2539
(650) 493-5000
Mailing address
514 MISSOURI ST, SAN FRANCISCO, CA 94107-2837
(612) 227-4123
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY 24592
CA
Other
Enumeration date
01/11/2013
Last updated
01/11/2013
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