Provider Demographics
NPI:1205363561
Name:SHEEN, DANIEL (LMFT)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:SHEEN
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1940 S PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-6003
Mailing Address - Country:US
Mailing Address - Phone:310-221-1719
Mailing Address - Fax:
Practice Address - Street 1:1940 S PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-6003
Practice Address - Country:US
Practice Address - Phone:310-221-1719
Practice Address - Fax:310-221-1719
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-17
Last Update Date:2017-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT94335106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist