Provider Demographics
NPI:1689300386
Name:DANENBERG, SALLIE ANN (LMFT)
Entity Type:Individual
Prefix:
First Name:SALLIE
Middle Name:ANN
Last Name:DANENBERG
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1660 HAMILTON AVE
Mailing Address - Street 2:UITE 206
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95125
Mailing Address - Country:US
Mailing Address - Phone:408-298-8703
Mailing Address - Fax:408-298-8713
Practice Address - Street 1:1660 HAMILTON AVE
Practice Address - Street 2:UITE 206
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95125
Practice Address - Country:US
Practice Address - Phone:408-298-8703
Practice Address - Fax:408-298-8713
Is Sole Proprietor?:No
Enumeration Date:2022-07-26
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC25414106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist