Provider Demographics
NPI:1073083820
Name:LEONE, DANIEL (LMFT)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:
Last Name:LEONE
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13841 TUSTIN EAST DR APT 16
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-5367
Mailing Address - Country:US
Mailing Address - Phone:949-910-2089
Mailing Address - Fax:
Practice Address - Street 1:13841 TUSTIN EAST DR
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-5328
Practice Address - Country:US
Practice Address - Phone:714-656-4695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-04
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA139091101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA19283701Medicaid