Provider Demographics
NPI:1326888215
Name:KOOREN, DANIEL PATRICK (MSW, ACSW)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:PATRICK
Last Name:KOOREN
Suffix:
Gender:M
Credentials:MSW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6304 CASTLE CARY DR
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93306-7065
Mailing Address - Country:US
Mailing Address - Phone:661-308-6913
Mailing Address - Fax:
Practice Address - Street 1:6304 CASTLE CARY DR
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93306-7065
Practice Address - Country:US
Practice Address - Phone:661-308-6913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-29
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW107921390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program