Provider Demographics
NPI: | 1598133001 |
---|---|
Name: | SENECHARLES, DANIELLE (CNM, WHNP, RN) |
Entity type: | Individual |
Prefix: | |
First Name: | DANIELLE |
Middle Name: | |
Last Name: | SENECHARLES |
Suffix: | |
Gender: | F |
Credentials: | CNM, WHNP, RN |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | PO BOX 743749 |
Mailing Address - Street 2: | |
Mailing Address - City: | LOS ANGELES |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 90074-3749 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1001 POTRERO AVE |
Practice Address - Street 2: | BLDG. 5, #6D |
Practice Address - City: | SAN FRANCISCO |
Practice Address - State: | CA |
Practice Address - Zip Code: | 94110-3518 |
Practice Address - Country: | US |
Practice Address - Phone: | 415-206-5679 |
Practice Address - Fax: | |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2015-09-14 |
Last Update Date: | 2025-02-04 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CA | 95032171 | 363LW0102X |
NY | 704223 | 163W00000X |
CA | CNM236464 | 367A00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 367A00000X | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife | |
No | 363LW0102X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Women's Health |
No | 163W00000X | Nursing Service Providers | Registered Nurse |