Active NPI
Daniel Green, CCHT
- Renal Dialysis Technician
- Spring Valley, CA
National Provider Identifier
1861731200
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Renal Dialysis Technician
- License
- 00019263
- Practice address
- 1609 Tarleton St
Spring Valley, CA 91977-3741 - Phone
- (619) 402-8277
- NPI assigned
- Feb 5, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Renal Dialysis Technician | 2472R0900X | 00019263 | CA | Primary |
Addresses
Primary practice location
1609 Tarleton St
Spring Valley, CA 91977-3741
Mailing address
1609 Tarleton St
Spring Valley, CA 91977-3741
Phone (619) 402-8277
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00019263 | CA | MD | Renal Dialysis Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1360022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1360022400000",
"number": "1861731200",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1609 TARLETON ST",
"city": "SPRING VALLEY",
"state": "CA",
"postal_code": "919773741",
"telephone_number": "619-402-8277"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1609 TARLETON ST",
"city": "SPRING VALLEY",
"state": "CA",
"postal_code": "919773741",
"telephone_number": "619-402-8277"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "DANIEL",
"credential": "CCHT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-02-05",
"last_updated": "2013-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "2472R0900X",
"taxonomy_group": "",
"desc": "Technician, Other, Renal Dialysis",
"state": "CA",
"license": "00019263",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spring Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.