Individual provider Active NPI

Dennafaye Daghlian, PA-C

  • Physician Assistant
  • San Diego, CA
National Provider Identifier
1639636004
Registry record updated Mar 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
56534 Issued in CA
Practice address
15004 Innovation Dr
San Diego, CA 92128-3498
Phone
(858) 605-7837
NPI assigned
Feb 21, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 56534 CA Primary

Addresses

Primary practice location

15004 Innovation Dr
San Diego, CA 92128-3498

Mailing address

10790 Rancho Bernardo Rd # 4S-205
San Diego, CA 92127-5705
Phone (858) 605-7171

Other names 1

  • Dennafaye Herald Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190429002670 CA Practitioner - Physician Assistant 3870835564 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Scripps HealthGroup PAC ID 9234033853, 1,450 clinicians

Practice addresses (Care Compare)

9888 Genesee Ave
La Jolla, CA 92037-1205
Phone (858) 626-4123

9896 Genesee Ave
La Jolla, CA 92037-1205
Phone (858) 626-4123

9898 Genesee Ave
La Jolla, CA 92037-1205
Phone (858) 455-9100

Hospital & facility affiliations

  • Scripps Memorial Hospital la Jolla Hospital, La Jolla, CA, CCN 050324

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
56534CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Current Accepting new patients
Scripps Health Physician Assistant CurrentSince Apr 1, 2019 Accepting new patients
Scripps Health CurrentSince Apr 1, 2019 Accepting new patients
Scripps Health Current Accepting new patients
Scripps Clinic Medical Group Past Accepting new patients

Locations

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

File 54433
Los Angeles, CA 90074
Phone (858) 784-5645

15004 Innovation Dr
San Diego, CA 92128
Phone (858) 487-1800

10790 Rancho Bernardo Rd
#4S205
San Diego, CA 92127
Phone (858) 605-7171

3811 Valley Centre Dr
#S99
San Diego, CA 92130
Phone (858) 554-3200

10790 Rancho Bernardo Rd
San Diego, CA 92127
Phone (858) 554-2626

Interoperability endpoints

  • Direct secure messaging: dherald201420@scrippshlth.medalliesdirect.net

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1550707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1639636004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10790 RANCHO BERNARDO RD # 4S-205",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275705",
            "telephone_number": "858-605-7171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15004 INNOVATION DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921283498",
            "telephone_number": "858-605-7837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAGHLIAN",
        "first_name": "DENNAFAYE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-21",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "56534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DENNAFAYE",
            "last_name": "HERALD",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.