Provider Demographics
NPI:1518246107
Name:DANIELS-SOMMERS, STACI DEANNA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:STACI
Middle Name:DEANNA
Last Name:DANIELS-SOMMERS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:STACI
Other - Middle Name:DEANNA
Other - Last Name:DANIELS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1385
Mailing Address - Street 2:
Mailing Address - City:CANYON COUNTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91386-1385
Mailing Address - Country:US
Mailing Address - Phone:248-884-2008
Mailing Address - Fax:
Practice Address - Street 1:24509 WALNUT ST STE 201
Practice Address - Street 2:
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321-2846
Practice Address - Country:US
Practice Address - Phone:661-765-8426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-12
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010932641041C0700X
CA894761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical