Provider Demographics
NPI:1225689417
Name:TZARFATI BLAUNSTAIN, DANIELA NELI
Entity Type:Individual
Prefix:
First Name:DANIELA
Middle Name:NELI
Last Name:TZARFATI BLAUNSTAIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4499 MADOC WAY
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95130-2044
Mailing Address - Country:US
Mailing Address - Phone:408-838-5131
Mailing Address - Fax:408-838-5131
Practice Address - Street 1:4499 MADOC WAY
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95130-2044
Practice Address - Country:US
Practice Address - Phone:408-838-5131
Practice Address - Fax:408-838-5131
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-27
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT115677101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health