Healthcare Provider Details

I. General information

NPI: 1417180779
Provider Name (Legal Business Name): DANIELLE BELCASTRO-BISBIKIS M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2009
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 BROADWAY
SACRAMENTO CA
95820-1527
US

IV. Provider business mailing address

5060 SHOREHAM PL STE 330
SAN DIEGO CA
92122-5976
US

V. Phone/Fax

Practice location:
  • Phone: 916-827-5464
  • Fax:
Mailing address:
  • Phone: 877-840-6956
  • Fax: 619-383-6701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number80471
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: