Provider Demographics
NPI:1518620756
Name:PATTERSON, DANIELLE (PNP)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2405 BERNARDO AVE
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92029-5616
Mailing Address - Country:US
Mailing Address - Phone:858-382-3478
Mailing Address - Fax:
Practice Address - Street 1:6475 ALVARADO RD STE 120
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92120-5007
Practice Address - Country:US
Practice Address - Phone:619-539-7459
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-14
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95018300363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics