Provider Demographics
NPI:1063028678
Name:ALBERT, DANIEL JOSHUA
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:JOSHUA
Last Name:ALBERT
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 1:30079 N CLOVER WAY
Mailing Address - Street 2:
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85143-7537
Mailing Address - Country:US
Mailing Address - Phone:480-452-4346
Mailing Address - Fax:
Practice Address - Street 1:538 S GILBERT RD STE 101
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-2270
Practice Address - Country:US
Practice Address - Phone:480-482-5005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-18
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician