Provider Demographics
NPI:1801315171
Name:THOMAS, DANIELLE MARIE (NP)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:MARIE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:MARIE
Other - Last Name:DAVIES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:35808 CHALET CT
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-1840
Mailing Address - Country:US
Mailing Address - Phone:858-525-5019
Mailing Address - Fax:
Practice Address - Street 1:40285 WINCHESTER RD STE 103
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-5547
Practice Address - Country:US
Practice Address - Phone:951-296-5844
Practice Address - Fax:951-296-5840
Is Sole Proprietor?:No
Enumeration Date:2017-09-18
Last Update Date:2017-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95007413363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner