Healthcare Provider Details

I. General information

NPI: 1841142395
Provider Name (Legal Business Name): DANIEL DERRICK
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2026
Last Update Date: 02/09/2026
Certification Date: 02/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2044 FILLMORE ST 2NF FLOOR, PACIFIC HEIGHTS DISTRICT
SAN FRANCISCO CA
94115-2777
US

IV. Provider business mailing address

2044 FILLMORE ST 2NF FLOOR, PACIFIC HEIGHTS DISTRICT
SAN FRANCISCO CA
94115-2777
US

V. Phone/Fax

Practice location:
  • Phone: 415-888-8368
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: