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NPI Code Detail

MEDICARE: ROSE HATHAWAY DAKIN RN

MEDICARE: ROSE HATHAWAY DAKIN RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program95388780CA

General Provider Information

NPI Number : 1194654731
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROSE HATHAWAY DAKIN RN
Provider Business Mailing Address
First Line : 907 KEY ROUTE BLVD
Second Line :
City : ALBANY
State : CA
Zip : 94706-2121
Country : US
Telephone Number : 510-543-5185
Fax Number :
Provider Business Practice Location Address
First Line : 1287 FULTON RD
Second Line :
City : SANTA ROSA
State : CA
Zip : 95401-4923
Country : US
Telephone Number : 707-800-7700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2026
Last Update Date : 05/19/2026

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