Provider Demographics
NPI:1326411240
Name:GUDNASON, DANIELLE KRSINICH MILLER (ND)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:KRSINICH MILLER
Last Name:GUDNASON
Suffix:
Gender:F
Credentials:ND
Other - Prefix:DR
Other - First Name:DANIELLE
Other - Middle Name:
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ND
Mailing Address - Street 1:15895 JACKSON OAKS DR
Mailing Address - Street 2:
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-6803
Mailing Address - Country:US
Mailing Address - Phone:916-837-3668
Mailing Address - Fax:844-395-8837
Practice Address - Street 1:50 E MAIN AVE STE A
Practice Address - Street 2:
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-3661
Practice Address - Country:US
Practice Address - Phone:408-664-0404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-02
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND1338175F00000X
WANT60610911175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAND1338OtherCALIFORNIA NATUROPATHIC MEDICAL BOARD