Basic Information
| Provider Information | |||||||||
| NPI: | 1093468902 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DIGRAZIA | ||||||||
| FirstName: | DANIELA | ||||||||
| MiddleName: | L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 276 VALLEY CREEK LN APT A | ||||||||
| Address2: | |||||||||
| City: | DANVILLE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945262549 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9258227842 | ||||||||
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| Practice Location | |||||||||
| Address1: | 39201 STATE ST | ||||||||
| Address2: | |||||||||
| City: | FREMONT | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945381437 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8662062008 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/31/2022 | ||||||||
| LastUpdateDate: | 02/01/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 02/01/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.