Provider Demographics
NPI:1871125567
Name:VONOCH, DANIELLE
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:VONOCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 63
Mailing Address - Street 2:
Mailing Address - City:CUTTEN
Mailing Address - State:CA
Mailing Address - Zip Code:95534-0063
Mailing Address - Country:US
Mailing Address - Phone:707-268-8722
Mailing Address - Fax:707-268-0218
Practice Address - Street 1:3960 WALNUT DR
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95503-8938
Practice Address - Country:US
Practice Address - Phone:707-268-8722
Practice Address - Fax:707-268-0218
Is Sole Proprietor?:No
Enumeration Date:2020-02-10
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X, 101YM0800X
CA19020101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health