Provider Demographics
NPI:1629513460
Name:DANIEL, VERONICA EILEEN (LCSW)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:EILEEN
Last Name:DANIEL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14212 VOLTERRA WAY
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:CA
Mailing Address - Zip Code:92223-6314
Mailing Address - Country:US
Mailing Address - Phone:714-728-6070
Mailing Address - Fax:
Practice Address - Street 1:6296 MAGNOLIA AVE # 1186
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-2526
Practice Address - Country:US
Practice Address - Phone:714-728-6070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-04
Last Update Date:2023-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA102947101YM0800X, 1041C0700X
CAASW84276101YM0800X
106S00000X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program