Provider Demographics
NPI:1710091475
Name:HABER, DANIELLE ANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:ANNE
Last Name:HABER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12625 HIGH BLUFF DR STE 215
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-2054
Mailing Address - Country:US
Mailing Address - Phone:858-401-9922
Mailing Address - Fax:858-408-7922
Practice Address - Street 1:12625 HIGH BLUFF DR STE 215
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-2054
Practice Address - Country:US
Practice Address - Phone:858-401-9922
Practice Address - Fax:858-408-7922
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2014-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG549252084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G549250Medicaid
G81148Medicare UPIN
CA00G549250Medicaid