Provider Demographics
NPI:1336992015
Name:CANN MAKE A DIFFERENCE
Entity Type:Organization
Organization Name:CANN MAKE A DIFFERENCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMFT
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:R
Authorized Official - Last Name:ECKER
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:559-569-9838
Mailing Address - Street 1:3724 N 1ST ST STE B
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93726-5601
Mailing Address - Country:US
Mailing Address - Phone:559-569-9838
Mailing Address - Fax:
Practice Address - Street 1:3724 N 1ST ST STE B
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-5601
Practice Address - Country:US
Practice Address - Phone:559-569-9838
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA103565OtherDEPARTMENT OF CONSUMER AFFAIRS