MEDICARE: MRS. ERIKA RENEE DANIELS LCSW

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	1041C0700X	Clinical Social Worker	21835	CA

General Provider Information

NPI Number	:	1801901442
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ERIKA RENEE DANIELS LCSW

Provider Business Mailing Address
First Line	:	27261 LAS RAMBLAS STE 200
Second Line	:
City	:	MISSION VIEJO
State	:	CA
Zip	:	92691-6472
Country	:	US
Telephone Number	:	909-980-6700
Fax Number	:	909-557-2146

Provider Business Practice Location Address
First Line	:	9500 HAVEN AVE STE 200
Second Line	:
City	:	RANCHO CUCAMONGA
State	:	CA
Zip	:	91730-5839
Country	:	US
Telephone Number	:	909-980-6700
Fax Number	:	909-557-2146

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

Provider Enumeration Date	:	08/21/2006
Last Update Date	:	12/05/2017

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