Provider Demographics
NPI:1083863047
Name:MUMFORD, DANIELLE LOUISE (MS, MFTI)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:LOUISE
Last Name:MUMFORD
Suffix:
Gender:F
Credentials:MS, MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2513 YOUNGSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95380-9707
Mailing Address - Country:US
Mailing Address - Phone:209-667-0327
Mailing Address - Fax:
Practice Address - Street 1:2513 YOUNGSTOWN RD
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95380-9707
Practice Address - Country:US
Practice Address - Phone:209-725-2125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-15
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA83277101YP2500X, 106H00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program