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NPI Code Detail

MEDICARE: DANIEL VAN STAAVEREN

MEDICARE: DANIEL VAN STAAVEREN
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
1313M00000XNursing Facility/Intermediate Care Facility252727CA

General Provider Information

NPI Number : 1356268213
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIEL VAN STAAVEREN
Provider Business Mailing Address
First Line : 2426 E OAKMONT AVE
Second Line :
City : FRESNO
State : CA
Zip : 93730-5953
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2426 E OAKMONT AVE
Second Line :
City : FRESNO
State : CA
Zip : 93730-5953
Country : US
Telephone Number : 559-288-1390
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2026
Last Update Date : 07/01/2026

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Directions to “ DANIEL VAN STAAVEREN ” Practice Location

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