Provider Demographics
NPI:1568798775
Name:DANIEL, MAUREEN (MA: MFT)
Entity Type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:
Last Name:DANIEL
Suffix:
Gender:F
Credentials:MA: MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2099 MT DIABLO BLVD
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-8495
Mailing Address - Country:US
Mailing Address - Phone:925-947-0935
Mailing Address - Fax:707-425-8784
Practice Address - Street 1:325 N WIGET LN
Practice Address - Street 2:SUITE 130
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2435
Practice Address - Country:US
Practice Address - Phone:925-935-5425
Practice Address - Fax:707-425-8784
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-22
Last Update Date:2009-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28353106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist