Healthcare Provider Details

I. General information

NPI: 1538674130
Provider Name (Legal Business Name): DANIELLE NAHAS PROFESSIONAL ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2017
Last Update Date: 11/21/2024
Certification Date: 11/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2108 N ST # 10258
SACRAMENTO CA
95816-5712
US

IV. Provider business mailing address

1314 E LAS OLAS BLVD # 1079
FT LAUDERDALE FL
33301-2334
US

V. Phone/Fax

Practice location:
  • Phone: 415-902-7879
  • Fax:
Mailing address:
  • Phone: 415-902-7879
  • Fax: 858-437-6450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number27313
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-13-13509
License Number StateNULL

VIII. Authorized Official

Name: DR. DANIELLE NAHAS
Title or Position: CALIFORNIA LICENSED PSYCHOLOGIST
Credential: PSYD
Phone: 415-902-7879