MEDICARE: DANALYN CLEMENTE

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	163W00000X	Registered Nurse	796266	CA

General Provider Information

NPI Number	:	1679997290
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANALYN CLEMENTE

Provider Business Mailing Address
First Line	:	2293 LOS PADRES BLVD
Second Line	:	APT 2
City	:	SANTA CLARA
State	:	CA
Zip	:	95050-6819
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2293 LOS PADRES BLVD
Second Line	:	APT 2
City	:	SANTA CLARA
State	:	CA
Zip	:	95050-6819
Country	:	US
Telephone Number	:	408-912-4134
Fax Number	:

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

Provider Enumeration Date	:	02/18/2014
Last Update Date	:	02/18/2014

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