Provider Demographics
NPI:1457919938
Name:COX, DANIEL (CADC11)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:COX
Suffix:
Gender:M
Credentials:CADC11
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 22ND ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-3503
Mailing Address - Country:US
Mailing Address - Phone:916-442-3979
Mailing Address - Fax:916-442-3577
Practice Address - Street 1:500 22ND ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-3503
Practice Address - Country:US
Practice Address - Phone:916-442-4519
Practice Address - Fax:916-446-4939
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-30
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA061030322101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA941665387OtherNON-PROFIT