Healthcare Provider Details

I. General information

NPI: 1215286976
Provider Name (Legal Business Name): DANNA MARIA BROCK CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DANNA MARIA LORENZETTI CNP

II. Dates (important events)

Enumeration Date: 09/09/2012
Last Update Date: 05/17/2026
Certification Date: 05/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3883 AIRWAY DR STE 320
SANTA ROSA CA
95403-1671
US

IV. Provider business mailing address

3883 AIRWAY DR STE 320
SANTA ROSA CA
95403-1671
US

V. Phone/Fax

Practice location:
  • Phone: 707-521-7750
  • Fax: 707-573-5427
Mailing address:
  • Phone: 707-521-7750
  • Fax: 707-573-5427

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP95003529
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberA0912016
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: