Provider Demographics
NPI:1316092422
Name:STAGNER, DANIELLE CAROLYN
Entity type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:CAROLYN
Last Name:STAGNER
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:DANIELLE
Other - Middle Name:CAROLYN
Other - Last Name:LAWRENCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2001 THE ALAMEDA
Mailing Address - Street 2:MOMENTUM FOR MENTAL HEALTH
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-1136
Mailing Address - Country:US
Mailing Address - Phone:408-261-7777
Mailing Address - Fax:408-254-9960
Practice Address - Street 1:206 S CALIFORNIA AVE
Practice Address - Street 2:MOMENTUM FOR MENTAL HEALTH SERVICE TEAM ADULT CALIFOR
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-1618
Practice Address - Country:US
Practice Address - Phone:650-617-8340
Practice Address - Fax:650-321-5468
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator