Provider Demographics
NPI:1205040102
Name:DUNSTAN-MCDANIEL, ALMA (MFT)
Entity Type:Individual
Prefix:MS
First Name:ALMA
Middle Name:
Last Name:DUNSTAN-MCDANIEL
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 ASH AVE.
Mailing Address - Street 2:
Mailing Address - City:SAN ANSELMO
Mailing Address - State:CA
Mailing Address - Zip Code:94960-1480
Mailing Address - Country:US
Mailing Address - Phone:415-460-5483
Mailing Address - Fax:415-459-2740
Practice Address - Street 1:44 ASH AVE.
Practice Address - Street 2:
Practice Address - City:SAN ANSELMO
Practice Address - State:CA
Practice Address - Zip Code:94960-1480
Practice Address - Country:US
Practice Address - Phone:415-460-5483
Practice Address - Fax:415-459-2740
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 39522106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA11701231OtherCAQH