Healthcare Provider Details

I. General information

NPI: 1588147995
Provider Name (Legal Business Name): DANIKA SUMAYANG LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2018
Last Update Date: 05/07/2024
Certification Date: 05/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 GRANT RD
MOUNTAIN VIEW CA
94040-4302
US

IV. Provider business mailing address

PO BOX 1334
SANTA CLARA CA
95052-1334
US

V. Phone/Fax

Practice location:
  • Phone: 650-940-7346
  • Fax: 650-962-5715
Mailing address:
  • Phone: 650-940-7346
  • Fax: 650-962-5715

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number108305
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: