Individual provider Active NPI

Danielle Canales, BCBA, LMFT

  • Marriage & Family Therapist
  • Fairfield, CA
National Provider Identifier
1215487665
Registry record updated Apr 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMF125201 Issued in CA
Practice address
2420 Martin Rd Ste 200
Fairfield, CA 94534-8610
Phone
(707) 399-4520
NPI assigned
Oct 10, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LMF125201 CA Primary

Addresses

Primary practice location

2420 Martin Rd Ste 200
Fairfield, CA 94534-8610

Mailing address

2420 Martin Rd Ste 200
Fairfield, CA 94534-8610
Phone (707) 399-4520

Other practice location 1

801 Empire St
Fairfield, CA 94533-5702
Phone (707) 425-5744

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LMF125201CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Clinics PastSince Apr 11, 2021 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1476057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617926400000",
    "number": "1215487665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2420 MARTIN RD STE 200",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945348610",
            "telephone_number": "707-399-4520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2420 MARTIN RD STE 200",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945348610",
            "telephone_number": "707-399-4520"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 Empire St",
            "address_purpose": "LOCATION",
            "city": "Fairfield",
            "state": "CA",
            "postal_code": "945335702",
            "country_code": "US",
            "telephone_number": "707-425-5744",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CANALES",
        "first_name": "DANIELLE",
        "credential": "BCBA, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-10",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMF125201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.