Provider Demographics
NPI:1306344825
Name:TSEGAY, DANIEL W (DNP, FNP-BC)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:W
Last Name:TSEGAY
Suffix:
Gender:M
Credentials:DNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 SARATOGA AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95050-5638
Mailing Address - Country:US
Mailing Address - Phone:415-747-0998
Mailing Address - Fax:
Practice Address - Street 1:600 ALFRED NOBEL DR STE A
Practice Address - Street 2:
Practice Address - City:HERCULES
Practice Address - State:CA
Practice Address - Zip Code:94547-1834
Practice Address - Country:US
Practice Address - Phone:510-984-1103
Practice Address - Fax:888-628-9895
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-30
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA804474163W00000X
CA95008837363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse