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General NPI Number Information
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NPI Number | 1669874160
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Entity Type | Individual
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Provider Name | DANIEL S BROWN PH.D.
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Gender | Male
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Dates
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Enumeration Date | 09/16/2014
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Last Update Date | 09/16/2014
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Provider Practice Location Address
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Address Line | 505 SAN MARIN DR STE A150
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City | NOVATO
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State | CA
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Zip | 94945-1309
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Country | US
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Telephone | 415-264-8892
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 444
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City | LAGUNITAS
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State | CA
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Zip | 94938-0444
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Country | US
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Telephone | 415-488-9686
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Fax |
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSB36298
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License Number State | CA
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