Provider Demographics
NPI:1275645285
Name:DANTO, JOAN M (LCSW)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:M
Last Name:DANTO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 N HARBOR BLVD
Mailing Address - Street 2:SUITE 440
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835
Mailing Address - Country:US
Mailing Address - Phone:714-992-5111
Mailing Address - Fax:951-735-6755
Practice Address - Street 1:1400 N HARBOR BLVD
Practice Address - Street 2:SUITE 440
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835
Practice Address - Country:US
Practice Address - Phone:714-992-5111
Practice Address - Fax:951-735-6755
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS0115431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LCS11543OtherBLUE CROSS
LCS11543OtherBLUE CROSS