Healthcare Provider Details

I. General information

NPI: 1942355086
Provider Name (Legal Business Name): DANIEL B FRONCZAK PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

969 BROADWAY
OAKLAND CA
94607-4017
US

IV. Provider business mailing address

1804 ELLIS ST APT A
SAN FRANCISCO CA
94115-4049
US

V. Phone/Fax

Practice location:
  • Phone: 510-251-3906
  • Fax: 510-251-3954
Mailing address:
  • Phone: 415-225-7736
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License NumberPSB 32633
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: