Provider Demographics
NPI:1699553024
Name:MCDANIELS, CLEAPATRA JANAYA (NONE)
Entity type:Individual
Prefix:MS
First Name:CLEAPATRA
Middle Name:JANAYA
Last Name:MCDANIELS
Suffix:
Gender:F
Credentials:NONE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2568 GROVE WAY APT 3
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-7231
Mailing Address - Country:US
Mailing Address - Phone:510-978-0152
Mailing Address - Fax:
Practice Address - Street 1:2568 GROVE WAY APT 3
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-7231
Practice Address - Country:US
Practice Address - Phone:510-978-0152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
CA103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst