Healthcare Provider Details
I. General information
NPI: 1295729002
Provider Name (Legal Business Name): DANIELLE NAEGLE RNP-C, MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/07/2005
Last Update Date: 12/21/2021
Certification Date: 12/21/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1000 W CARSON ST N-28
TORRANCE CA
90502-2004
US
IV. Provider business mailing address
1101 VIA FRANCISCA
SAN PEDRO CA
90732-2304
US
V. Phone/Fax
- Phone: 310-222-3723
- Fax:
- Phone: 310-831-5916
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LX0001X |
| Taxonomy | Obstetrics & Gynecology Nurse Practitioner |
| License Number | RN548885 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: