Provider Demographics
NPI:1417718974
Name:CHINN, DANIEL (MSW)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:CHINN
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3067 TIERRA MESA
Mailing Address - Street 2:
Mailing Address - City:ATASCADERO
Mailing Address - State:CA
Mailing Address - Zip Code:93422-1569
Mailing Address - Country:US
Mailing Address - Phone:805-835-2062
Mailing Address - Fax:
Practice Address - Street 1:4401 EL CAMINO REAL
Practice Address - Street 2:SUITE E
Practice Address - City:ATASCADERO
Practice Address - State:CA
Practice Address - Zip Code:93422-1569
Practice Address - Country:US
Practice Address - Phone:805-835-2062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW122161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical