Active NPI
Melissa Daniels, PSYD
- Clinical Psychologist
- Victorville, CA
National Provider Identifier
1740720580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY32680
- Practice address
- 12625 Hesperia Rd
Victorville, CA 92395-7720 - Phone
- (760) 995-8300
- NPI assigned
- Feb 27, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY32680 | CA | Primary |
| Counselor | 101Y00000X |
Addresses
Primary practice location
12625 Hesperia Rd
Victorville, CA 92395-7720
Mailing address
1330 E Cooley Dr
Colton, CA 92324-3905
Phone (909) 580-3705
Other practice location 1
1330 E Cooley Dr
Colton, CA 92324-3905
Phone (909) 580-3705
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY32680 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1488153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656547200000",
"number": "1740720580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1330 E COOLEY DR",
"city": "COLTON",
"state": "CA",
"postal_code": "923243905",
"telephone_number": "909-580-3705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12625 HESPERIA RD",
"city": "VICTORVILLE",
"state": "CA",
"postal_code": "923957720",
"telephone_number": "760-995-8300"
}
],
"practiceLocations": [
{
"address_1": "1330 E Cooley Dr",
"address_purpose": "LOCATION",
"city": "Colton",
"state": "CA",
"postal_code": "923243905",
"country_code": "US",
"telephone_number": "909-580-3705",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DANIELS",
"first_name": "MELISSA",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-02-27",
"last_updated": "2022-06-30",
"certification_date": "2022-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY32680",
"primary": true
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Victorville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.