Provider Demographics
NPI:1518623818
Name:MCDANIEL, REBECCA IRENE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:IRENE
Last Name:MCDANIEL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:IRENE
Other - Last Name:MCDANIEL-DE CAMPOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:2816 ATADERO CT
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-9201
Mailing Address - Country:US
Mailing Address - Phone:619-273-2946
Mailing Address - Fax:
Practice Address - Street 1:2816 ATADERO CT
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009-9201
Practice Address - Country:US
Practice Address - Phone:619-273-2946
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-10
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA865341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical