Healthcare Provider Details

I. General information

NPI: 1154757755
Provider Name (Legal Business Name): ERIN DANIAL NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2013
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 SOTOYOME ST STE 201
SANTA ROSA CA
95405-4822
US

IV. Provider business mailing address

121 SOTOYOME ST STE 201
SANTA ROSA CA
95405-4822
US

V. Phone/Fax

Practice location:
  • Phone: 707-573-8984
  • Fax: 707-573-0982
Mailing address:
  • Phone: 707-573-8984
  • Fax: 707-573-0982

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number23437
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: