Provider Demographics
NPI:1437704442
Name:ATENCIO, DANIELLE SOPHIA (LCSW)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:SOPHIA
Last Name:ATENCIO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11549 LOS OSOS VALLEY RD STE 103
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93405-6457
Mailing Address - Country:US
Mailing Address - Phone:805-471-5389
Mailing Address - Fax:
Practice Address - Street 1:11549 LOS OSOS VALLEY RD STE 103
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93405-6457
Practice Address - Country:US
Practice Address - Phone:805-471-5389
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-06
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA143770442101YM0800X, 1041C0700X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical