Provider Demographics
NPI:1952434094
Name:DANIELS, TREVOR ALLEN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:TREVOR
Middle Name:ALLEN
Last Name:DANIELS
Suffix:
Gender:M
Credentials:PSYD
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 1426
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93232-1426
Mailing Address - Country:US
Mailing Address - Phone:818-321-7419
Mailing Address - Fax:
Practice Address - Street 1:1029 N DEMAREE ST
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-4117
Practice Address - Country:US
Practice Address - Phone:818-321-7419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY31238103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist