| Doctor Name: | DR. DANIELLE WEST VANDEVENTER |
| NPI Number: | 1033493036 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | 24448 |
| Business Practice Address: | 631 Woodside Rd Redwood City, CA - 940613847 |
| Business Phone Number: | 6503679030 |
| Business Fax Number: | 6503679032 |
| Mailing Address: | 631 Woodside Rd, REDWOOD CITY |
| State: | CA |
| Postal Code: | 940613847 |
| Phone Number: | 6503679030 |
| Fax Number: | 6503679032 |
| NPI Enumeration Date: | 10/10/2011 |
| NPI Last Update Date: | 10/10/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 24448 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |