Provider Demographics
NPI:1558027037
Name:FRAZIER, DANIEL K SR (RAC)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:K
Last Name:FRAZIER
Suffix:SR
Gender:M
Credentials:RAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14926 HAWTHORNE BLVD APT 105
Mailing Address - Street 2:
Mailing Address - City:LAWNDALE
Mailing Address - State:CA
Mailing Address - Zip Code:90260-1568
Mailing Address - Country:US
Mailing Address - Phone:323-301-5168
Mailing Address - Fax:
Practice Address - Street 1:515 E 6TH ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90021-1009
Practice Address - Country:US
Practice Address - Phone:213-529-0963
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-09
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)