Provider Demographics
NPI:1326646357
Name:SAGARMINAGA, DANIELLE FRANCES TIPTON (AMFT, APCC)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:FRANCES TIPTON
Last Name:SAGARMINAGA
Suffix:
Gender:F
Credentials:AMFT, APCC
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:FRANCES
Other - Last Name:TIPTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AMFT, APCC
Mailing Address - Street 1:PO BOX 32042
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94604-3342
Mailing Address - Country:US
Mailing Address - Phone:415-747-8178
Mailing Address - Fax:
Practice Address - Street 1:361 3RD ST STE B
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-3580
Practice Address - Country:US
Practice Address - Phone:415-747-8178
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-12
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6682101YP2500X
CA114640101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional