person
Jerry Dattilo, BA
Mental Health Counselor in San Mateo, California
NPI 1669997854

Jerry Dattilo is a Mental Health Counselor based in San Mateo, CA and is specialized in Mental Health. Jerry Dattilo practices in San Mateo, CA and has the professional credentials of BA. The NPI Number for Jerry Dattilo is 1669997854 and holds a License No. (California).

The current practice location address for Jerry Dattilo is 2600 S El Camino Real Ste 200, San Mateo, CA and can be reached out via phone at 650-513-6122 and via fax at 650-513-6122.

Location: 2600 S El Camino Real Ste 200, San Mateo, CA, 94403-2382
person
Provider Profile Details
NPI Number
1669997854
Provider Name
Jerry Dattilo
Credential
BA
Provider Entity Type
Individual
Gender
Male
Address
2600 S El Camino Real Ste 200, San Mateo, CA, 94403-2382
Phone Number
650-513-6122
Fax Number
650-513-6122
Provider Enumeration Date
08/08/2017
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1861530107 01 CA EMPLOYER
institution
Provider Business Practice Location Address Details
Address
2600 S El Camino Real Ste 200
City
State
Zip
94403-2382
Phone Number
650-513-6122
Fax Number
650-513-6122
person
Provider Business Mailing Address Details
Address
2600 S El Camino Real Ste 200
City
State
Zip
94403-2382
Phone Number
650-513-6122
Fax Number
650-513-6122
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
(California)
Definition
Definition to come...
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