Provider Demographics
NPI:1700103314
Name:CASAGRANDE, DAREN ALLEN (LMFT)
Entity Type:Individual
Prefix:
First Name:DAREN
Middle Name:ALLEN
Last Name:CASAGRANDE
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 E COVELL BLVD STE B5-313
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-1366
Mailing Address - Country:US
Mailing Address - Phone:855-773-7615
Mailing Address - Fax:855-773-7615
Practice Address - Street 1:315 MACE BLVD
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95618
Practice Address - Country:US
Practice Address - Phone:855-773-7615
Practice Address - Fax:855-773-7615
Is Sole Proprietor?:No
Enumeration Date:2010-04-23
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA92438101Y00000X, 101YA0400X, 101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional