Healthcare Provider Details

I. General information

NPI: 1225050537
Provider Name (Legal Business Name): DANIEL NONE VIGIL MFCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 09/03/2024
Certification Date: 09/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31878 DEL OBISPO ST STE 118-384
SAN JUAN CAPISTRANO CA
92675-3223
US

IV. Provider business mailing address

31878 DEL OBISPO ST # 118-384
SAN JUAN CAPISTRANO CA
92675-3223
US

V. Phone/Fax

Practice location:
  • Phone: 949-586-1703
  • Fax: 949-481-1825
Mailing address:
  • Phone: 949-586-1703
  • Fax: 949-586-4033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMK19214
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: