Provider Demographics
NPI:1902213283
Name:DANBERG, ANNE DEBORAH (MA)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:DEBORAH
Last Name:DANBERG
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2173 FRANCISCO BLVD E STE F
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94901-5523
Mailing Address - Country:US
Mailing Address - Phone:415-302-4542
Mailing Address - Fax:
Practice Address - Street 1:2173 FRANCISCO BLVD E STE F
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-5523
Practice Address - Country:US
Practice Address - Phone:415-332-2898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-17
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA96816106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist