Provider Demographics
NPI:1164394821
Name:CALLAHAN, PAUL DANIEL
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:DANIEL
Last Name:CALLAHAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3870 MURPHY CANYON RD STE 320-325
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-4446
Mailing Address - Country:US
Mailing Address - Phone:858-262-8504
Mailing Address - Fax:858-300-0461
Practice Address - Street 1:3870 MURPHY CANYON RD STE 320-325
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-4446
Practice Address - Country:US
Practice Address - Phone:858-262-8504
Practice Address - Fax:858-300-0461
Is Sole Proprietor?:No
Enumeration Date:2025-09-22
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAPCC20167101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional