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General NPI Number Information
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NPI Number | 1659694073
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Entity Type | Individual
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Provider Name | DANIEL JONATHAN LANZARIN IV CADC-CAS C031100215
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Gender | Male
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Dates
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Enumeration Date | 03/12/2010
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Last Update Date | 08/12/2025
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Provider Practice Location Address
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Address Line | 550 QUARRY RD FL 3
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City | SAN CARLOS
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State | CA
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Zip | 94070-6221
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Country | US
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Telephone | 650-421-3502
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Fax | 650-598-2860
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Provider Business Mailing Address
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Address Line | 550 QUARRY RD 3RD FLOOR
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City | SAN CARLOS
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State | CA
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Zip | 94070
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Country | US
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Telephone | 650-508-6745
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Fax | 650-599-9273
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | C031100215
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 122789
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | C031100215
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number | C031100215
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License Number State | CA
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