Healthcare Provider Details

I. General information

NPI: 1134242878
Provider Name (Legal Business Name): MR. DANIEL NIEVES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15339 SATICOY ST
VAN NUYS CA
91406-3345
US

IV. Provider business mailing address

1209 PINE ST APT D
SOUTH PASADENA CA
91030-4385
US

V. Phone/Fax

Practice location:
  • Phone: 818-605-7789
  • Fax:
Mailing address:
  • Phone: 323-482-3684
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number138068
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW131376
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberASW131376
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: