MEDICARE: ANNE DEBORAH DANBERG MA

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	96816	CA

General Provider Information

NPI Number	:	1902213283
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNE DEBORAH DANBERG MA

Provider Business Mailing Address
First Line	:	2173 FRANCISCO BLVD E STE F
Second Line	:
City	:	SAN RAFAEL
State	:	CA
Zip	:	94901-5523
Country	:	US
Telephone Number	:	415-302-4542
Fax Number	:

Provider Business Practice Location Address
First Line	:	2173 FRANCISCO BLVD E STE F
Second Line	:
City	:	SAN RAFAEL
State	:	CA
Zip	:	94901-5523
Country	:	US
Telephone Number	:	415-332-2898
Fax Number	:

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

Provider Enumeration Date	:	07/17/2014
Last Update Date	:	08/20/2019

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