Healthcare Provider Details

I. General information

NPI: 1679452999
Provider Name (Legal Business Name): DANIELLE GETTY RD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2025
Last Update Date: 08/29/2025
Certification Date: 08/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 FRANQUETTE AVE STE A2
CONCORD CA
94520-7958
US

IV. Provider business mailing address

207 CASTLE ROCK RD
WALNUT CREEK CA
94598-4516
US

V. Phone/Fax

Practice location:
  • Phone: 857-540-9103
  • Fax:
Mailing address:
  • Phone: 857-540-9103
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number925022
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: