Provider Demographics
NPI:1740090448
Name:BAUER, DANIELLE ANNE (NP)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:ANNE
Last Name:BAUER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:ANNE
Other - Last Name:WERINGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:7213 OCOTILLO ST
Mailing Address - Street 2:
Mailing Address - City:SANTEE
Mailing Address - State:CA
Mailing Address - Zip Code:92071-5657
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9850 GENESEE AVE STE 320
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1208
Practice Address - Country:US
Practice Address - Phone:858-554-1212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95031612363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner