Provider Demographics
NPI:1013974682
Name:BASS, DANIEL H (LCSW)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:H
Last Name:BASS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 E TAHQUITZ CANYON WAY
Mailing Address - Street 2:STE 201
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262
Mailing Address - Country:US
Mailing Address - Phone:760-325-4088
Mailing Address - Fax:760-778-3781
Practice Address - Street 1:801 E TAHQUITZ CANYON WAY
Practice Address - Street 2:STE 201
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262
Practice Address - Country:US
Practice Address - Phone:760-325-4088
Practice Address - Fax:760-778-3781
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS10953101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MMM00427MMedicare ID - Type Unspecified