Provider Demographics
NPI:1467798223
Name:POWERS, DANAE (MS)
Entity type:Individual
Prefix:
First Name:DANAE
Middle Name:
Last Name:POWERS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154A W FOOTHILL BLVD # 334
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-3847
Mailing Address - Country:US
Mailing Address - Phone:626-385-7284
Mailing Address - Fax:
Practice Address - Street 1:583 N MOUNTAIN AVE
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-5016
Practice Address - Country:US
Practice Address - Phone:626-385-7284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-26
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCTLC311MFT106H00000X
UTMFT13142902-3902106H00000X
FLTPMF792106H00000X
IDLMFT9223106H00000X
MOMFT2022050150106H00000X
OHIMFTF.2200304106H00000X
VT100.0134144TELE106H00000X
VALMFT0717001984106H00000X
CALMFT52528106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist