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General NPI Number Information
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NPI Number | 1639895659
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Entity Type | Individual
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Provider Name | DANIEL JOSEPH WILLS CHRISTEY
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Gender | Male
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Dates
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Enumeration Date | 10/12/2022
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 1692 EL CAMINO REAL
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City | SAN CARLOS
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State | CA
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Zip | 94070-5208
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Country | US
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Telephone | 508-179-0706
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Fax |
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Provider Business Mailing Address
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Address Line | 389 ACCACIA ST
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City | DALY CITY
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State | CA
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Zip | 94014-1510
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Country | US
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Telephone | 209-728-7891
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 373H00000X
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Taxonomy Name | Day Training/Habilitation Specialist
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License Number |
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License Number State |
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