Provider Demographics
NPI:1366814816
Name:DOYLE, JAMES ANDREW (MS)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:ANDREW
Last Name:DOYLE
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:870 N MOUNTAIN AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-4173
Mailing Address - Country:US
Mailing Address - Phone:626-753-8680
Mailing Address - Fax:
Practice Address - Street 1:870 N MOUNTAIN AVE STE 206
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-4173
Practice Address - Country:US
Practice Address - Phone:626-753-8680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-23
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALPCC16670101YP2500X
101Y00000X
CA101YM0800X
CA8541101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health