Provider Demographics
NPI:1821376898
Name:HIBBITTS, DANIELLE J (MS, MA, PSY D)
Entity Type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:J
Last Name:HIBBITTS
Suffix:
Gender:F
Credentials:MS, MA, PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 N SUTTER ST STE 400
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95202-2911
Mailing Address - Country:US
Mailing Address - Phone:510-872-8122
Mailing Address - Fax:
Practice Address - Street 1:20 N SUTTER ST STE 400
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95202-2911
Practice Address - Country:US
Practice Address - Phone:510-872-8122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-25
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSB94022734103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSB94022734OtherBOARD OF PSYCHOLOGY, PSYCHOLOGICAL ASSISTANT