Provider Demographics
NPI:1366218869
Name:DOOLEY, VERNON
Entity type:Individual
Prefix:
First Name:VERNON
Middle Name:
Last Name:DOOLEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3527 MOUNT DIABLO BLVD
Mailing Address - Street 2:PMB 171
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549
Mailing Address - Country:US
Mailing Address - Phone:209-479-4239
Mailing Address - Fax:
Practice Address - Street 1:1415 OAKLAND BLVD STE 203
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-4395
Practice Address - Country:US
Practice Address - Phone:925-378-9456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-27
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
CA144079106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator