Individual
DR. MARC D. KOMORI STAGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
1600 S MAIN ST, SUITE 225, WALNUT CREEK, CA 94596-5340
(925) 325-5022
Mailing address
1600 S MAIN ST, SUITE 225, WALNUT CREEK, CA 94596-5340
(925) 325-5022
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY 21734
CA
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TF0000X
Family Psychologist
—
—
Other
Enumeration date
11/27/2006
Last updated
09/27/2011
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