Provider Demographics
NPI:1548797582
Name:DANIELS, NORMANDY (MFT)
Entity Type:Individual
Prefix:
First Name:NORMANDY
Middle Name:
Last Name:DANIELS
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:917 WESTERN DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94801-3765
Mailing Address - Country:US
Mailing Address - Phone:415-735-1926
Mailing Address - Fax:
Practice Address - Street 1:941 THE ALAMEDA
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94707-2316
Practice Address - Country:US
Practice Address - Phone:415-735-1926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-22
Last Update Date:2017-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95110106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist