Provider Demographics
NPI:1679866974
Name:HARPOLD, DANIEL ROSS (MFT)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:ROSS
Last Name:HARPOLD
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:MR
Other - First Name:ROSS
Other - Middle Name:
Other - Last Name:HARPOLD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MFT
Mailing Address - Street 1:6310 SAN VICENTE BLVD
Mailing Address - Street 2:SUITE 410
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-5426
Mailing Address - Country:US
Mailing Address - Phone:323-578-2734
Mailing Address - Fax:
Practice Address - Street 1:6310 SAN VICENTE BLVD
Practice Address - Street 2:SUITE 410
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-5426
Practice Address - Country:US
Practice Address - Phone:323-578-2734
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-18
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40008106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist