Provider Demographics
NPI:1952690414
Name:SHABANI, DANIEL B (PHD, BCBA-D)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:B
Last Name:SHABANI
Suffix:
Gender:M
Credentials:PHD, BCBA-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 5TH ST
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-5713
Mailing Address - Country:US
Mailing Address - Phone:310-310-2931
Mailing Address - Fax:323-747-7023
Practice Address - Street 1:405 5TH ST
Practice Address - Street 2:
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-5713
Practice Address - Country:US
Practice Address - Phone:310-310-2931
Practice Address - Fax:323-747-7023
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-05
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1010664103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-01-0664OtherBCBA