Provider Demographics
NPI:1205039732
Name:DAGGETT, VERONICA ELAINE (DO)
Entity Type:Individual
Prefix:DR
First Name:VERONICA
Middle Name:ELAINE
Last Name:DAGGETT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 PROVIDENCE MINE ROAD
Mailing Address - Street 2:SUITE 215
Mailing Address - City:NEVADA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95959
Mailing Address - Country:US
Mailing Address - Phone:530-265-2425
Mailing Address - Fax:
Practice Address - Street 1:206 PROVIDENCE MINE ROAD
Practice Address - Street 2:SUITE 215
Practice Address - City:NEVADA CITY
Practice Address - State:CA
Practice Address - Zip Code:95959
Practice Address - Country:US
Practice Address - Phone:530-265-2425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A6976207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine