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General NPI Number Information
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NPI Number | 1518437714
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Entity Type | Individual
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Provider Name | DANIEL WATKINS
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Gender | Male
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Dates
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Enumeration Date | 11/29/2018
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Last Update Date | 06/27/2022
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Provider Practice Location Address
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Address Line | 409 JEFFERSON ST
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City | PETALUMA
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State | CA
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Zip | 94952-3105
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Country | US
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Telephone | 707-763-3393
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Fax |
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Provider Business Mailing Address
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Address Line | 409 JEFFERSON ST
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City | PETALUMA
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State | CA
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Zip | 94952-3105
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Country | US
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Telephone | 707-763-3393
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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 | 344600000X
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Taxonomy Name | Taxi
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License Number | 44306E1
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 344600000X
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Taxonomy Name | Taxi
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License Number | C588618
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License Number State | CA
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