David Wesley Condiff, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY3941 Issued in CA

Practice address

1114 E Route 66
Glendora, CA 91740-3771

Phone

(626) 335-1218

Fax

(626) 335-1210

NPI assigned

Feb 8, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280793600000",
    "number": "1831162296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1114 E ROUTE 66",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917403771",
            "telephone_number": "626-335-1218",
            "fax_number": "626-335-1210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1114 E ROUTE 66",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917403771",
            "telephone_number": "626-335-1218",
            "fax_number": "626-335-1210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONDIFF",
        "first_name": "DAVID",
        "middle_name": "WESLEY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2010-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY3941",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 5410",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6669619",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Glendora, CA
• Providers in Glendora, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.