Healthcare Provider Details

I. General information

NPI: 1932300423
Provider Name (Legal Business Name): DANIELLE MCCAULEY RD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DANIELLE SEXTON RD

II. Dates (important events)

Enumeration Date: 05/30/2007
Last Update Date: 07/12/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1620 N 16TH ST
BOISE ID
83702-2639
US

IV. Provider business mailing address

1620 N 16TH ST
BOISE ID
83702-2639
US

V. Phone/Fax

Practice location:
  • Phone: 916-201-9659
  • Fax:
Mailing address:
  • Phone: 916-201-9659
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number980353
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number6671169
License Number StateID
# 3
Primary TaxonomyY
Taxonomy Code133VN1201X
TaxonomyObesity and Weight Management Nutrition Registered Dietitian
License Number6671169
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: