Individual
MR. DOUGLAS D CITRO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
17782 COWAN, STE A, IRVINE, CA 92614-6041
(714) 290-1770
(949) 208-6981
Mailing address
17782 COWAN, STE A, IRVINE, CA 92614-6041
(714) 290-1770
(949) 208-6981
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
CP8510
CA
103T00000X
Psychologist
PSY202312
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00PL851000
BLUE SHIELD
CA
05
—
PSY085100
—
CA
Enumeration date
08/01/2006
Last updated
02/15/2017
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