Provider Demographics
NPI:1407291859
Name:SIEVERS, DARIA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:DARIA
Middle Name:
Last Name:SIEVERS
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 1:1368 LINCOLN AVE
Mailing Address - Street 2:SUITE 211
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94901-2147
Mailing Address - Country:US
Mailing Address - Phone:415-302-9130
Mailing Address - Fax:415-456-6680
Practice Address - Street 1:1368 LINCOLN AVE
Practice Address - Street 2:SUITE 211
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-2147
Practice Address - Country:US
Practice Address - Phone:415-302-9130
Practice Address - Fax:415-456-6680
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-29
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS102531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical