Basic Information
| Provider Information | |||||||||
| NPI: | 1861920456 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HASENZAHL | ||||||||
| FirstName: | DANIELA | ||||||||
| MiddleName: | ESMERALDA | ||||||||
| NamePrefix: | |||||||||
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| Credential: | CATC I | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1225 W 6TH ST | ||||||||
| Address2: | |||||||||
| City: | SANTA ANA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 927032101 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7149721402 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1225 W 6TH ST | ||||||||
| Address2: | |||||||||
| City: | SANTA ANA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 927032101 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7149721402 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/26/2017 | ||||||||
| LastUpdateDate: | 12/30/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 12/30/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | 1710727 | CA | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.