Provider Demographics
NPI:1487767992
Name:DAVIDSON, STEVEN CRAIG (PHD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:CRAIG
Last Name:DAVIDSON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7445
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92658-7445
Mailing Address - Country:US
Mailing Address - Phone:949-233-0234
Mailing Address - Fax:
Practice Address - Street 1:1101 DOVE ST
Practice Address - Street 2:SUITE 240
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2839
Practice Address - Country:US
Practice Address - Phone:949-233-0234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY13162103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical