Provider Demographics
NPI:1265315865
Name:BRUYN, DANI JUNI
Entity type:Individual
Prefix:
First Name:DANI
Middle Name:JUNI
Last Name:BRUYN
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 1:5552 VALLEJO ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94608-2624
Mailing Address - Country:US
Mailing Address - Phone:510-919-6978
Mailing Address - Fax:
Practice Address - Street 1:1727 MARTIN LUTHER KING JR WAY STE 109
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-1358
Practice Address - Country:US
Practice Address - Phone:510-846-3292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-30
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program