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General NPI Number Information
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NPI Number | 1952808149
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Entity Type | Individual
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Provider Name | DANIEL JOHN PICKRELL DO
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Gender | Male
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Dates
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Enumeration Date | 04/12/2018
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Last Update Date | 08/22/2024
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Provider Practice Location Address
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Address Line | 3305 PLACER ST STE B
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City | REDDING
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State | CA
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Zip | 96001-2378
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Country | US
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Telephone | 530-225-6805
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Fax | 530-262-6592
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Provider Business Mailing Address
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Address Line | 4216 VIDA VERDE LN NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-1609
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Country | US
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Telephone | 520-491-9874
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 11405456-1204
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 2084P0802X
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Taxonomy Name | Addiction Psychiatry Physician
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License Number | DO2023-0179
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License Number State | NM
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