Healthcare Provider Details

I. General information

NPI: 1154252765
Provider Name (Legal Business Name): DANIEL ANGEL CANO LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

252 ESTHER ST
COSTA MESA CA
92627-2220
US

IV. Provider business mailing address

25932 VIA DEL SUR
MISSION VIEJO CA
92691-4038
US

V. Phone/Fax

Practice location:
  • Phone: 972-971-8108
  • Fax:
Mailing address:
  • Phone: 972-971-8108
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number137648
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: