MEDICARE: MS. DORA DANIELS LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	128385	CA
2	106H00000X	Marriage & Family Therapist	TPMF1293	FL

General Provider Information

NPI Number	:	1053894758
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DORA DANIELS LMFT

Provider Business Mailing Address
First Line	:	3559 FERNWOOD AVE
Second Line	:
City	:	LYNWOOD
State	:	CA
Zip	:	90262-3485
Country	:	US
Telephone Number	:	415-569-0834
Fax Number	:

Provider Business Practice Location Address
First Line	:	3559 FERNWOOD AVE
Second Line	:
City	:	LYNWOOD
State	:	CA
Zip	:	90262-3485
Country	:	US
Telephone Number	:	415-569-0834
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/10/2018
Last Update Date	:	04/13/2026

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