Healthcare Provider Details

I. General information

NPI: 1134028020
Provider Name (Legal Business Name): DANIELLE GLARSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2026
Last Update Date: 11/05/2026
Certification Date: 11/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4805 BECHELLI LN
REDDING CA
96002-3556
US

IV. Provider business mailing address

4805 BECHELLI LN
REDDING CA
96002-3556
US

V. Phone/Fax

Practice location:
  • Phone: 530-222-8097
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number93027
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: