Provider Demographics
NPI:1215900915
Name:STERNBERG, DANIEL PAUL (PHD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:PAUL
Last Name:STERNBERG
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 58275
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84158-0275
Mailing Address - Country:US
Mailing Address - Phone:801-364-2779
Mailing Address - Fax:801-582-9360
Practice Address - Street 1:150 S 600 E
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84102-1999
Practice Address - Country:US
Practice Address - Phone:801-364-2779
Practice Address - Fax:801-364-3336
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT106262-2501103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical