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General NPI Number Information
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NPI Number | 1003701640
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Entity Type | Individual
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Provider Name | TENZIN DADEN
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Gender | Female
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Dates
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Enumeration Date | 06/12/2025
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 2089 VALE RD STE 33
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City | SAN PABLO
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State | CA
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Zip | 94806-3850
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Country | US
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Telephone | 341-215-2051
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Fax |
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Provider Business Mailing Address
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Address Line | 4026 LA COLINA RD
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City | EL SOBRANTE
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State | CA
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Zip | 94803-2918
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Country | US
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Telephone | 510-710-4115
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA66716
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License Number State | CA
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