Provider Demographics
NPI:1073764726
Name:STOREVIK, DANIELLE MARIE
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:MARIE
Last Name:STOREVIK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3845 SPRING DR
Mailing Address - Street 2:18
Mailing Address - City:SPRING VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91977-1030
Mailing Address - Country:US
Mailing Address - Phone:619-281-3706
Mailing Address - Fax:619-797-1091
Practice Address - Street 1:3845 SPRING DR
Practice Address - Street 2:18
Practice Address - City:SPRING VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91977-1030
Practice Address - Country:US
Practice Address - Phone:619-281-3706
Practice Address - Fax:619-797-1091
Is Sole Proprietor?:No
Enumeration Date:2008-09-30
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist