| Dani Nierenberg Phd Bcb Pllc | |
|
108 Se 124th Ave Ste 12 Vancouver WA 98684-6015 | |
| (360) 713-8171 | |
| (360) 210-4039 |
| Full Name | Dani Nierenberg Phd Bcb Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 108 Se 124th Ave Ste 12, Vancouver, Washington |
| Authorized Official Name and Position | Dani Nierenberg (OWNER) |
| Authorized Official Contact | 3607138171 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dani Nierenberg Phd Bcb Pllc 850 Nw View Ridge Ct Camas WA 98607-9051 Ph: () - | Dani Nierenberg Phd Bcb Pllc 108 Se 124th Ave Ste 12 Vancouver WA 98684-6015 Ph: (360) 713-8171 |
| NPI Number | 1265055172 |
|---|---|
| Provider Enumeration Date | 05/27/2020 |
| Last Update Date | 05/27/2020 |
| Certification Date | 05/27/2020 |
| Medicare PECOS PAC ID | 5799107322 |
|---|---|
| Medicare Enrollment ID | O20200626001302 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265055172 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Dani Nierenberg |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1760604631 PECOS PAC ID: 9537300306 Enrollment ID: I20200630000773 |
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