Healthcare Provider Details

I. General information

NPI: 1902225816
Provider Name (Legal Business Name): DANIELLE E. HARIK DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2014
Last Update Date: 03/11/2021
Certification Date: 03/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6095 N 1ST ST
FRESNO CA
93710-5444
US

IV. Provider business mailing address

1230 SHAFFER RD APT 3308
SANTA CRUZ CA
95060-5783
US

V. Phone/Fax

Practice location:
  • Phone: 559-446-1515
  • Fax: 559-261-1239
Mailing address:
  • Phone: 269-358-2006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberPG167648
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO00904
License Number StateRI
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number18396
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: