Provider Demographics
NPI:1255679577
Name:TAPANES, DANIEL KEVIN (MFT)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:KEVIN
Last Name:TAPANES
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1131 N DEARBORN ST
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92374-4947
Mailing Address - Country:US
Mailing Address - Phone:909-633-7202
Mailing Address - Fax:
Practice Address - Street 1:1325 S AUTO PLAZA DR STE 130
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-2763
Practice Address - Country:US
Practice Address - Phone:909-885-5757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-21
Last Update Date:2013-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47642106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist