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NPI Code Detail

MEDICARE: DANIEL ROBERT DOUGLAS LMFT #103178

MEDICARE:   DANIEL ROBERT DOUGLAS  LMFT #103178
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
1106H00000XMarriage & Family Therapist103178CA

General Provider Information

NPI Number : 1982151809
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIEL ROBERT DOUGLAS LMFT #103178
Provider Business Mailing Address
First Line : 201 BERKELEY AVE
Second Line :
City : ROSEVILLE
State : CA
Zip : 95678-2205
Country : US
Telephone Number : 916-468-3306
Fax Number : 916-468-3306
Provider Business Practice Location Address
First Line : 201 BERKELEY AVE
Second Line :
City : ROSEVILLE
State : CA
Zip : 95678-2205
Country : US
Telephone Number : 916-468-3306
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2016
Last Update Date : 02/01/2022

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Directions to “ DANIEL ROBERT DOUGLAS LMFT #103178” Practice Location

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