Provider Demographics
NPI:1679845788
Name:SWANSON, DANIELLE LYNN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:LYNN
Last Name:SWANSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9436 N SAYBROOK DR APT 141
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-0640
Mailing Address - Country:US
Mailing Address - Phone:315-323-2021
Mailing Address - Fax:
Practice Address - Street 1:3010 N DEMAREE ST
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-7147
Practice Address - Country:US
Practice Address - Phone:559-734-5861
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-04
Last Update Date:2012-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA66728183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist