Individual
DANAMAYA GORHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
222 W 39TH AVE, SAN MATEO, CA 94403-4364
(650) 573-2222
Mailing address
222 W 39TH AVE, SAN MATEO, CA 94403-4364
(650) 573-2222
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
333629
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RN333629
—
CA
Enumeration date
12/05/2008
Last updated
12/08/2008
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