=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386597326
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MR. DANIEL ROBERT LIVINGSTON
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/18/2026
-----------------------------------------------------
Last Update Date | 02/18/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2900 BRISTOL ST STE C208
-----------------------------------------------------
City | COSTA MESA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92626-5946
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 949-381-1510
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 17595 HARVARD AVE STE C-939
-----------------------------------------------------
City | IRVINE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92614-8516
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 949-414-6244
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | 153183
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------