Provider Demographics
NPI:1720263528
Name:CISNEROS, DANIELLE LYNANN (MA)
Entity type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:LYNANN
Last Name:CISNEROS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39755 MURRIETA HOT SPRINGS RD STE D160
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-9113
Mailing Address - Country:US
Mailing Address - Phone:951-294-5393
Mailing Address - Fax:951-257-1071
Practice Address - Street 1:39755 MURRIETA HOT SPRINGS RD STE D160
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-9113
Practice Address - Country:US
Practice Address - Phone:951-285-2282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-31
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53552106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist