Provider Demographics
NPI:1003650466
Name:TAMAYO, DANIEL FERNANDEZ (DNP)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:FERNANDEZ
Last Name:TAMAYO
Suffix:
Gender:M
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 PACIFIC BAY CIR APT 304
Mailing Address - Street 2:
Mailing Address - City:SAN BRUNO
Mailing Address - State:CA
Mailing Address - Zip Code:94066-6140
Mailing Address - Country:US
Mailing Address - Phone:702-885-2282
Mailing Address - Fax:
Practice Address - Street 1:5562 PHILADELPHIA ST STE 301
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-2499
Practice Address - Country:US
Practice Address - Phone:713-589-5283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-20
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN61209743163W00000X
CA95405892163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse