Healthcare Provider Details

I. General information

NPI: 1326530445
Provider Name (Legal Business Name): DANICA DRUE BARNICLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2018
Last Update Date: 10/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 MISSION AVE STE 230
OCEANSIDE CA
92058-7110
US

IV. Provider business mailing address

3609 OCEAN RANCH BLVD STE 110
OCEANSIDE CA
92056-8601
US

V. Phone/Fax

Practice location:
  • Phone: 760-712-3535
  • Fax: 760-439-6901
Mailing address:
  • Phone: 760-967-4475
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number92235
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: