Provider Demographics
NPI:1609504224
Name:GOLAN, DANIEL (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:GOLAN
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:
Other - Last Name:GOLAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, LMFT
Mailing Address - Street 1:1501 LINCOLN BLVD # 1101
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:CA
Mailing Address - Zip Code:90291-3503
Mailing Address - Country:US
Mailing Address - Phone:424-274-0518
Mailing Address - Fax:
Practice Address - Street 1:1990 N CALIFORNIA BLVD STE 20 PMB 1036
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596
Practice Address - Country:US
Practice Address - Phone:424-274-0518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-11
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA134068106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist