Basic Information
| Provider Information | |||||||||
| NPI: | 1285663104 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCQUAID | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | ROBERT | ||||||||
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| Credential: | PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | VA SAN DIEGO HEALTHCARE SYSTEM (116-B) | ||||||||
| Address2: | 3350 LA JOLLA VILLAGE DR. | ||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92161 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8586423693 | ||||||||
| FaxNumber: | 8585527414 | ||||||||
| Practice Location | |||||||||
| Address1: | VA SAN DIEGO HEALTHCARE SYSTEM (116-B) | ||||||||
| Address2: | 3350 LA JOLLA VILLAGE DR. | ||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92161 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8586423693 | ||||||||
| FaxNumber: | 8585527414 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/02/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | PSY14922 | CA | X | Behavioral Health & Social Service Providers | Psychologist | 103TC0700X | PSY14922 | CA | X | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.