Individual
DANIEL THOMAS ENNACO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
18646 OXNARD ST, TARZANA, CA 91356-1411
(818) 996-1051
Mailing address
1804 S 8TH ST, ALHAMBRA, CA 91803-3419
(760) 797-5542
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
08/23/2016
Last updated
10/10/2019
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