Healthcare Provider Details

I. General information

NPI: 1619384385
Provider Name (Legal Business Name): DANIELA SYLVERS WEISE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2014
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 TAMAL VISTA BLVD STE 255
CORTE MADERA CA
94925-1173
US

IV. Provider business mailing address

555 NORTHGATE DR STE 100 FAMILY SERVICE AGENCY OF MARIN
SAN RAFAEL CA
94903-3696
US

V. Phone/Fax

Practice location:
  • Phone: 415-496-6020
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: