Provider Demographics
NPI:1427289313
Name:SKIBOLA, DANICA (MD)
Entity type:Individual
Prefix:DR
First Name:DANICA
Middle Name:
Last Name:SKIBOLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1470 MARIA LN STE 235
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-5343
Mailing Address - Country:US
Mailing Address - Phone:925-302-2640
Mailing Address - Fax:925-264-5943
Practice Address - Street 1:1470 MARIA LN STE 235
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-5343
Practice Address - Country:US
Practice Address - Phone:925-302-2640
Practice Address - Fax:925-264-5943
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-27
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1180382084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry