Provider Demographics
NPI:1144420308
Name:BRUNSWICK, DANIELLE SUSANNE
Entity Type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:SUSANNE
Last Name:BRUNSWICK
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:DANIELLE
Other - Middle Name:SUSANNE
Other - Last Name:MARKOWITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2579 SAN PABLO AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-1159
Mailing Address - Country:US
Mailing Address - Phone:510-446-7100
Mailing Address - Fax:
Practice Address - Street 1:2579 SAN PABLO AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-1159
Practice Address - Country:US
Practice Address - Phone:510-446-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-24
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health