Provider Demographics
NPI:1790411098
Name:BRANDYS, DANIELLE RAYZBERG (LMFT)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:RAYZBERG
Last Name:BRANDYS
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 1:700 EL CAMINO REAL SUITE 120
Mailing Address - Street 2:#1006
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025
Mailing Address - Country:US
Mailing Address - Phone:650-260-8009
Mailing Address - Fax:
Practice Address - Street 1:700 EL CAMINO REAL SUITE 120
Practice Address - Street 2:#1006
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025
Practice Address - Country:US
Practice Address - Phone:650-260-8009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-28
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA128853106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist