Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
Y | 1041C0700X | Clinical Social Worker | 99096 | CA |
NPI | 1003374497 |
---|---|
Provider Name | Danielle Chrisjan Stauffer |
First Address | Oakland, CA 94609-2633 |
Second Address | Oakland, CA 94609-2633 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2019 |
Last Update Date | 14/12/2020 |