Healthcare Provider Details

I. General information

NPI: 1720741549
Provider Name (Legal Business Name): DANA PAUL HEMMINGSEN FDN-P
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2021
Last Update Date: 10/19/2021
Certification Date: 10/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

197 RAMONA RD
DANVILLE CA
94526-2825
US

IV. Provider business mailing address

197 RAMONA RD
DANVILLE CA
94526-2825
US

V. Phone/Fax

Practice location:
  • Phone: 925-683-6275
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License NumberNA
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: