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Provider Information for 1295846822



DR. STACIE DANIELS M.D.

Gender: FEMALE

Individual NPI: 1295846822

Calendar Last Updated: 2008-03-11

Details

Name Value
NPI 1295846822
Enumeration Date 2006-08-31
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 1277 HOWARD ST # 2
SAN FRANCISCO, CA 94103-2711
United States

Phone: | Fax:
View Map External Link
Primary Practice Address 4501 SAND CREEK RD
ANTIOCH, CA 94531-8687
United States

Phone: 925-813-3840 | Fax: 925-813-3841
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 2084N0400X - Psychiatry & Neurology Neurology CA C52291