Healthcare Provider Details

I. General information

NPI: 1467747329
Provider Name (Legal Business Name): DARYL MCNEAL RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2011
Last Update Date: 02/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

144 STONY POINT RD
SANTA ROSA CA
95401-4122
US

IV. Provider business mailing address

1437 CARLETON DR
CONCORD CA
94518-1116
US

V. Phone/Fax

Practice location:
  • Phone: 707-521-4500
  • Fax: 707-544-4626
Mailing address:
  • Phone: 707-590-0974
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number819085
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: