MEDICARE: DANIELLE CHERRIE CAMPBELL 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	TPSW6529	FL
2	1041C0700X	Clinical Social Worker	132442	CA

General Provider Information

NPI Number	:	1841945847
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE CHERRIE CAMPBELL LCSW

Provider Business Mailing Address
First Line	:	23580 ALESSANDRO BLVD UNIT 7661
Second Line	:
City	:	MORENO VALLEY
State	:	CA
Zip	:	92552-6035
Country	:	US
Telephone Number	:	951-554-1494
Fax Number	:	951-380-8484

Provider Business Practice Location Address
First Line	:	23580 ALESSANDRO BLVD UNIT 7661
Second Line	:
City	:	MORENO VALLEY
State	:	CA
Zip	:	92552-6035
Country	:	US
Telephone Number	:	951-554-1494
Fax Number	:	951-380-8484

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

Provider Enumeration Date	:	02/17/2022
Last Update Date	:	03/16/2026

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