Healthcare Provider Details

I. General information

NPI: 1205791910
Provider Name (Legal Business Name): DANIEL BAGGETT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4805 GOLDEN FOOTHILL PKWY
EL DORADO HILLS CA
95762-9651
US

IV. Provider business mailing address

4805 GOLDEN FOOTHILL PKWY
EL DORADO HILLS CA
95762-9651
US

V. Phone/Fax

Practice location:
  • Phone: 530-644-2412
  • Fax: 530-869-1237
Mailing address:
  • Phone: 530-644-2412
  • Fax: 530-869-1237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: