Healthcare Provider Details

I. General information

NPI: 1740503093
Provider Name (Legal Business Name): DANIELLE DITTRICH DAWES NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DANIELLE MELISSA DITTRICH NP

II. Dates (important events)

Enumeration Date: 03/01/2010
Last Update Date: 10/13/2020
Certification Date: 10/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 WELCH RD UNIT B
PALO ALTO CA
94304-1601
US

IV. Provider business mailing address

725 WELCH RD UNIT B
PALO ALTO CA
94304-1601
US

V. Phone/Fax

Practice location:
  • Phone: 650-723-5403
  • Fax:
Mailing address:
  • Phone: 650-723-5403
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberNP20739
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberSP010728
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number20739
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: