=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588147995
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DANIKA SUMAYANG LCSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/11/2018
-----------------------------------------------------
Last Update Date | 05/07/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2500 GRANT RD
-----------------------------------------------------
City | MOUNTAIN VIEW
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94040-4302
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 650-940-7346
-----------------------------------------------------
Fax | 650-962-5715
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1334
-----------------------------------------------------
City | SANTA CLARA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95052-1334
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 650-940-7346
-----------------------------------------------------
Fax | 650-962-5715
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 108305
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------