Healthcare Provider Details

I. General information

NPI: 1033722244
Provider Name (Legal Business Name): DANIEL L. FIELDS CMT, MSTCM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: DAN FIELDS DACM

II. Dates (important events)

Enumeration Date: 08/26/2020
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4126 TELEGRAPH AVE
OAKLAND CA
94609-2406
US

IV. Provider business mailing address

6436 MOKELUMNE AVE
OAKLAND CA
94605-2209
US

V. Phone/Fax

Practice location:
  • Phone: 510-761-5550
  • Fax:
Mailing address:
  • Phone: 510-541-2946
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number68678
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: