Provider Demographics
NPI:1861539009
Name:GREENBERGER, DENNIS (PHD)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:
Last Name:GREENBERGER
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 1:1500 QUAIL ST
Mailing Address - Street 2:SUITE # 260
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2732
Mailing Address - Country:US
Mailing Address - Phone:949-222-2848
Mailing Address - Fax:949-863-1148
Practice Address - Street 1:1500 QUAIL ST
Practice Address - Street 2:SUITE # 260
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2732
Practice Address - Country:US
Practice Address - Phone:949-222-2848
Practice Address - Fax:949-863-1148
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY8533103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical