Healthcare Provider Details

I. General information

NPI: 1184336612
Provider Name (Legal Business Name): DANIEL COBAR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2022
Last Update Date: 11/01/2024
Certification Date: 11/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 LINCOLN AVE STE 200
SAN RAFAEL CA
94901-1221
US

IV. Provider business mailing address

2606 WHITE CRANE CIR
LIVERMORE CA
94550-7148
US

V. Phone/Fax

Practice location:
  • Phone: 415-322-0939
  • Fax:
Mailing address:
  • Phone: 925-413-6389
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number147629
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: