Individual
MARJORIE M DANIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1805 N CALIFORNIA ST, SUITE 101A, STOCKTON, CA 95204-6037
(209) 948-5515
(209) 948-9321
Mailing address
1144 NORMAN DR, SUITE 102, MANTECA, CA 95336-5925
(209) 823-1152
(209) 823-3376
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
NA230
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ03666Z
GROUP PTAN
CA
Enumeration date
10/23/2006
Last updated
01/04/2008
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