Most Relevant Information
Provider Data
| NPI Number: | 1003199944 |
| Provider Name: | DAVID CASSIDY |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/27/2011 |
| Last Updated: | 09/27/2011 |
Provider Practice Location
1756 S LEWIS RD
CAMARILLO
CA
930128520
Practice Location Phone/Fax
| Phone: | 8053833669 |
| Fax: | 8053833692 |
Provider Mailing Location
261 N 5TH ST
PORT HUENEME
CA
930413003
Provider Mailing Phone/Fax
| Phone: | 8053833669 |
| Fax: | 8053833692 |