Provider Demographics
NPI:1578709937
Name:SMEAD, DANYA MAREE (MFTI)
Entity Type:Individual
Prefix:MRS
First Name:DANYA
Middle Name:MAREE
Last Name:SMEAD
Suffix:
Gender:F
Credentials:MFTI
Other - Prefix:MS
Other - First Name:DANYA
Other - Middle Name:MAREE
Other - Last Name:TEIXEIRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFTI
Mailing Address - Street 1:1212 MCGINNESS AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95127-4025
Mailing Address - Country:US
Mailing Address - Phone:408-838-1202
Mailing Address - Fax:408-929-9011
Practice Address - Street 1:1212 MCGINNESS AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95127-4025
Practice Address - Country:US
Practice Address - Phone:408-838-1202
Practice Address - Fax:408-929-9011
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-06
Last Update Date:2009-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF 51307106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist