Provider Demographics
NPI:1225050537
Name:VIGIL, DANIEL NONE (MFCC)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:NONE
Last Name:VIGIL
Suffix:
Gender:M
Credentials:MFCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31878 DEL OBISPO ST # 118-384
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN CAPISTRANO
Mailing Address - State:CA
Mailing Address - Zip Code:92675-3223
Mailing Address - Country:US
Mailing Address - Phone:949-586-1703
Mailing Address - Fax:949-586-4033
Practice Address - Street 1:31878 DEL OBISPO ST STE 118-384
Practice Address - Street 2:
Practice Address - City:SAN JUAN CAPISTRANO
Practice Address - State:CA
Practice Address - Zip Code:92675-3223
Practice Address - Country:US
Practice Address - Phone:949-586-1703
Practice Address - Fax:949-481-1825
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMK19214106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist