Individual provider Active NPI

Danielle Lascano, AMFT

  • Mental Health Counselor
  • San Bernardino, CA
National Provider Identifier
1376295584
Registry record updated Jan 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
118247 Issued in CA
Practice address
18265 Evening Primrose LN
San Bernardino, CA 92407-0481
Phone
(909) 646-0339
NPI assigned
Jan 19, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 118247 CA Primary

Addresses

Primary practice location

18265 Evening Primrose LN
San Bernardino, CA 92407-0481

Mailing address

18265 Evening Primrose LN
San Bernardino, CA 92407-0481

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 11, 2024 through Apr 11, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
118247CAMDMental Health Counselor
131700CAMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1642550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1376295584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18265 EVENING PRIMROSE LN",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924070481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18265 EVENING PRIMROSE LN",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924070481",
            "telephone_number": "909-646-0339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASCANO",
        "first_name": "DANIELLE",
        "credential": "AMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-19",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "118247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.