MEDICARE: CHRISTOPHER DANIELSEN PMHNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	95036503	CA

General Provider Information

NPI Number	:	1346126836
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER DANIELSEN PMHNP

Provider Business Mailing Address
First Line	:	4455 SPECTRUM
Second Line	:
City	:	IRVINE
State	:	CA
Zip	:	92618-3384
Country	:	US
Telephone Number	:	951-992-7117
Fax Number	:	855-888-7818

Provider Business Practice Location Address
First Line	:	6500 WILSHIRE BLVD FL 19
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90048-4920
Country	:	US
Telephone Number	:	800-270-9256
Fax Number	:	855-888-7818

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2025
Last Update Date	:	03/02/2026

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