Basic Information
| Provider Information | |||||||||
| NPI: | 1326530445 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BARNICLE | ||||||||
| FirstName: | DANICA | ||||||||
| MiddleName: | DRUE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3609 OCEAN RANCH BLVD STE 110 | ||||||||
| Address2: | |||||||||
| City: | OCEANSIDE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920568601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7609674475 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1701 MISSION AVE STE 230 | ||||||||
| Address2: | |||||||||
| City: | OCEANSIDE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920587110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7607123535 | ||||||||
| FaxNumber: | 7604396901 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/04/2018 | ||||||||
| LastUpdateDate: | 10/08/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 101YM0800X | 92235 | CA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.