Provider Demographics
NPI:1003701640
Name:DADEN, TENZIN
Entity type:Individual
Prefix:
First Name:TENZIN
Middle Name:
Last Name:DADEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4026 LA COLINA RD
Mailing Address - Street 2:
Mailing Address - City:EL SOBRANTE
Mailing Address - State:CA
Mailing Address - Zip Code:94803-2918
Mailing Address - Country:US
Mailing Address - Phone:510-710-4115
Mailing Address - Fax:
Practice Address - Street 1:2089 VALE RD STE 33
Practice Address - Street 2:
Practice Address - City:SAN PABLO
Practice Address - State:CA
Practice Address - Zip Code:94806-3850
Practice Address - Country:US
Practice Address - Phone:341-215-2051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant