Provider Demographics
NPI:1568672707
Name:COHEN, DANIEL MATTHIEU (LCSW)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:MATTHIEU
Last Name:COHEN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1218 SANDELIN AVE
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-3945
Mailing Address - Country:US
Mailing Address - Phone:510-501-5961
Mailing Address - Fax:
Practice Address - Street 1:1814 FRANKLIN ST
Practice Address - Street 2:4TH FLOOR
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-3487
Practice Address - Country:US
Practice Address - Phone:510-613-0330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 287121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical