Provider Demographics
NPI:1902225816
Name:HARIK, DANIELLE E (DO)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:E
Last Name:HARIK
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 1:1230 SHAFFER RD APT 3308
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060-5783
Mailing Address - Country:US
Mailing Address - Phone:269-358-2006
Mailing Address - Fax:
Practice Address - Street 1:6095 N 1ST ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-5444
Practice Address - Country:US
Practice Address - Phone:559-446-1515
Practice Address - Fax:559-261-1239
Is Sole Proprietor?:No
Enumeration Date:2014-04-08
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPG167648207Q00000X
RIDO00904207Q00000X
CA18396207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine