Provider Demographics
NPI:1083861835
Name:SUMMERS, DANIELLE ANGELA (MA, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:ANGELA
Last Name:SUMMERS
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6242 SURFBOARD CIR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-5592
Mailing Address - Country:US
Mailing Address - Phone:949-737-3336
Mailing Address - Fax:949-752-3119
Practice Address - Street 1:2222 MARTIN
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-1458
Practice Address - Country:US
Practice Address - Phone:949-737-3336
Practice Address - Fax:949-752-3119
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-23
Last Update Date:2008-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 37877106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist