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General NPI Number Information
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NPI Number | 1710440953
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Entity Type | Individual
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Provider Name | DANIEL TELLO
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Gender | Male
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Dates
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Enumeration Date | 04/12/2019
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 525 21ST ST
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City | OAKLAND
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State | CA
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Zip | 94612-1605
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Country | US
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Telephone | 415-960-9048
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Fax |
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Provider Business Mailing Address
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Address Line | 3069 ALAMO DR # 170
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City | VACAVILLE
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State | CA
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Zip | 95687-6344
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Country | US
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Telephone | 916-917-9049
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 110037
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License Number State | CA
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