Provider Demographics
NPI:1245383496
Name:VERDONE, DANL K (MFT)
Entity Type:Individual
Prefix:MRS
First Name:DANL
Middle Name:K
Last Name:VERDONE
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:PO BOX 2412
Mailing Address - Street 2:
Mailing Address - City:CERES
Mailing Address - State:CA
Mailing Address - Zip Code:95307-8912
Mailing Address - Country:US
Mailing Address - Phone:209-573-1333
Mailing Address - Fax:209-579-5710
Practice Address - Street 1:2125 WYLIE DR
Practice Address - Street 2:SUITE 9
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-3800
Practice Address - Country:US
Practice Address - Phone:209-573-1333
Practice Address - Fax:209-579-5710
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC39193106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist