Healthcare Provider Details

I. General information

NPI: 1306356118
Provider Name (Legal Business Name): TATSIANA DANIELS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2017
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 SOLAR DR STE 100
OXNARD CA
93036-0647
US

IV. Provider business mailing address

2100 SOLAR DR STE 100
OXNARD CA
93036-0647
US

V. Phone/Fax

Practice location:
  • Phone: 805-988-9000
  • Fax: 805-988-9089
Mailing address:
  • Phone: 805-988-9000
  • Fax: 805-988-9089

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA55026
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: