Destefano, Michael G

Destefano, Michael G is an sole proprietor health care provider with primary practice located at 10333 El Camino Real , Atascadero CA 93422-5808. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Exercise & Sports, Behavioral Health & Social Service Providers / Psychoanalysis. Behavioral Health & Social Service Providers / Psychologist is his primary health care specialty. Destefano, Michael G can be contacted via phone (805) 468-2000.

Contact Information

Primary practice address
10333 El Camino Real Atascadero CA 93422-5808
Phone: (805) 468-2000
Fax: (805) 466-6011
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X PSY 4853 California
Behavioral Health & Social Service Providers / Exercise & Sports 103TE1100X PSY 4853 California
Behavioral Health & Social Service Providers / Psychoanalysis 103TP0814X PSY 4853 California

Profile Details

NPI number 1295912988
LBN Legal business name Destefano, Michael G
Credentials PHD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 25th, 2008
Last updated Jan 25th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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