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NPI Code Detail

MEDICARE: MRS. DANIELLE LEE GRIZZLE

MEDICARE: MRS. DANIELLE LEE GRIZZLE
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
1101Y00000XCounselor

General Provider Information

NPI Number : 1558889683
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DANIELLE LEE GRIZZLE
Provider Business Mailing Address
First Line : 368 FELL ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94102-5144
Country : US
Telephone Number : 415-861-0828
Fax Number : 415-861-0257
Provider Business Practice Location Address
First Line : 3371 PARKER HILL RD
Second Line :
City : SANTA ROSA
State : CA
Zip : 95404-1732
Country : US
Telephone Number : 707-535-0289
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2017
Last Update Date : 09/08/2017

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