Provider Demographics
NPI:1346452679
Name:STETTLER, DANYA KAYE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DANYA
Middle Name:KAYE
Last Name:STETTLER
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 1:13663 MONO WAY # 122-SOC
Mailing Address - Street 2:
Mailing Address - City:SONORA
Mailing Address - State:CA
Mailing Address - Zip Code:95370-2811
Mailing Address - Country:US
Mailing Address - Phone:209-588-2602
Mailing Address - Fax:209-588-2624
Practice Address - Street 1:13663 MONO WAY # 122-SOC
Practice Address - Street 2:
Practice Address - City:SONORA
Practice Address - State:CA
Practice Address - Zip Code:95370-2811
Practice Address - Country:US
Practice Address - Phone:209-588-2602
Practice Address - Fax:209-588-2624
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000052161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WALW00005216OtherLCSW WA