Provider Demographics
NPI:1124571906
Name:ANDRADE, DANIEL PAUL (LCSW)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:PAUL
Last Name:ANDRADE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 3RD ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94107-1214
Mailing Address - Country:US
Mailing Address - Phone:415-307-9204
Mailing Address - Fax:
Practice Address - Street 1:401 3RD ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94107-1214
Practice Address - Country:US
Practice Address - Phone:415-307-9204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-28
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW994371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALCSW99437OtherBOARD OF BEHAVIORAL SCIENCES