Provider Demographics
NPI:1235213570
Name:OFFNER, DANIEL MICHAEL (LCSW)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:MICHAEL
Last Name:OFFNER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 OLIVE ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-6215
Mailing Address - Country:US
Mailing Address - Phone:619-260-1872
Mailing Address - Fax:619-295-8098
Practice Address - Street 1:333 OLIVE ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-6215
Practice Address - Country:US
Practice Address - Phone:619-260-1872
Practice Address - Fax:619-295-8098
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 124191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA228902OtherMHN PROVIDER NUMBER
CALCS 12419OtherCA LICENSE NUMBER
CALCS 12419OtherCA LICENSE NUMBER