Provider Demographics
NPI:1962530618
Name:LIPKIN, DANIELLE RENA (MS, LMFT)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:RENA
Last Name:LIPKIN
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6371 HAVEN AVE # 3208
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91737-6943
Mailing Address - Country:US
Mailing Address - Phone:909-521-8389
Mailing Address - Fax:
Practice Address - Street 1:8350 ARCHIBALD AVE
Practice Address - Street 2:SUITE 125
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-3669
Practice Address - Country:US
Practice Address - Phone:909-521-8389
Practice Address - Fax:909-484-9280
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC46482106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist