Healthcare Provider Details

I. General information

NPI: 1285130419
Provider Name (Legal Business Name): DANIELLE IRENE BEATRICE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2018
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 N INDIAN HILL BLVD
CLAREMONT CA
91711-4348
US

IV. Provider business mailing address

3286 E GUASTI RD STE 100
ONTARIO CA
91761-8646
US

V. Phone/Fax

Practice location:
  • Phone: 909-476-2023
  • Fax:
Mailing address:
  • Phone: 909-476-2023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT164723
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: