Healthcare Provider Details

I. General information

NPI: 1396653325
Provider Name (Legal Business Name): RENEE DANIEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 BELLEVUE AVE
OAKLAND CA
94610-4923
US

IV. Provider business mailing address

520 DEL MAR AVE
PACIFICA CA
94044-1907
US

V. Phone/Fax

Practice location:
  • Phone: 707-596-9696
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW127483
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: