Provider Demographics
NPI:1427276161
Name:GRASS, DANIEL ERIK
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:ERIK
Last Name:GRASS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22328 SADDLEBACK RD
Mailing Address - Street 2:
Mailing Address - City:TEHACHAPI
Mailing Address - State:CA
Mailing Address - Zip Code:93561-7744
Mailing Address - Country:US
Mailing Address - Phone:661-822-4390
Mailing Address - Fax:
Practice Address - Street 1:16940 STATE HIGHWAY 14 STE H
Practice Address - Street 2:
Practice Address - City:MOJAVE
Practice Address - State:CA
Practice Address - Zip Code:93501-1238
Practice Address - Country:US
Practice Address - Phone:661-824-4938
Practice Address - Fax:661-824-4945
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health