Provider Demographics
NPI:1730204215
Name:CORRIGAN, DOUGLAS J (MA)
Entity type:Individual
Prefix:MR
First Name:DOUGLAS
Middle Name:J
Last Name:CORRIGAN
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44631 CEDAR AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-3510
Mailing Address - Country:US
Mailing Address - Phone:661-998-9669
Mailing Address - Fax:
Practice Address - Street 1:44631 CEDAR AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-3510
Practice Address - Country:US
Practice Address - Phone:661-998-9669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45525106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist