Provider Demographics
NPI:1710197165
Name:KU, DANIEL (MFT)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:KU
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 EMBARCADERO
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94606-5334
Mailing Address - Country:US
Mailing Address - Phone:510-846-6965
Mailing Address - Fax:
Practice Address - Street 1:2000 EMBARCADERO
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94606-5334
Practice Address - Country:US
Practice Address - Phone:510-846-6965
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT100424106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist