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NPI Code Detail

MEDICARE: DANIELLE KUMANDAN

MEDICARE: DANIELLE KUMANDAN
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
1103K00000XBehavior Analyst
2103K00000XBehavior Analyst1-16-22898

General Provider Information

NPI Number : 1780036699
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELLE KUMANDAN
Provider Business Mailing Address
First Line : 3650 MT DIABLO BLVD
Second Line :
City : LAFAYETTE
State : CA
Zip : 94549-3780
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3650 MT DIABLO BLVD
Second Line :
City : LAFAYETTE
State : CA
Zip : 94549-3780
Country : US
Telephone Number : 510-813-2569
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2016
Last Update Date : 06/12/2020

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