Brad Daniel

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

VN733632 Issued in CA

Practice address

2960 Blackhawk Dr
Willits, CA 95490-8770

Phone

(707) 367-1456

NPI assigned

Mar 24, 2025

Last updated

Mar 24, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1742774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742774400000",
    "number": "1033910252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2960 BLACKHAWK DR",
            "city": "WILLITS",
            "state": "CA",
            "postal_code": "954908770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2960 BLACKHAWK DR",
            "city": "WILLITS",
            "state": "CA",
            "postal_code": "954908770",
            "telephone_number": "707-367-1456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIEL",
        "first_name": "BRAD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-03-24",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "VN733632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Constance Susan Criswell, CRNA
• Jared Edan Cruz
• Phillip John D'Angelo, D.D.S.
• Erica D'Anis, CPNP
• Matthew D'Anis
• Suraya David-Sadira
• Jeremiah Reed Holmes Dawson, M.D.
• Tedd Eugene Dawson, MD
• Debora Rayhan D.D.S., Inc. (Willits Modern Dentistry)
• Richard P Dipman, MSW LCSW

• Licensed Vocational Nurse in Willits, CA
• Providers in Willits, CA by specialty
• Licensed Vocational Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.