Provider Demographics
NPI:1851570618
Name:WILLIAMS, DANIEL DEAN (MFT)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:DEAN
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3535 FARQUHAR AVE STE 16
Mailing Address - Street 2:SUITE 16
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-3937
Mailing Address - Country:US
Mailing Address - Phone:562-841-0932
Mailing Address - Fax:
Practice Address - Street 1:3535 FARQUHAR AVE
Practice Address - Street 2:SUITE 16
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-3937
Practice Address - Country:US
Practice Address - Phone:562-841-0932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-29
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC42617106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist