Provider Demographics
NPI:1396580999
Name:DAGMAN, INNA (CMT)
Entity type:Individual
Prefix:
First Name:INNA
Middle Name:
Last Name:DAGMAN
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2317 VINE HILL RD
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95065-9508
Mailing Address - Country:US
Mailing Address - Phone:415-672-4259
Mailing Address - Fax:
Practice Address - Street 1:320 RIVER ST
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-2723
Practice Address - Country:US
Practice Address - Phone:415-672-4259
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-26
Last Update Date:2025-07-22
Deactivation Date:2025-06-03
Deactivation Code:
Reactivation Date:2025-07-22
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula