Provider Demographics
NPI:1033853072
Name:ACHI, DANI (NP)
Entity Type:Individual
Prefix:
First Name:DANI
Middle Name:
Last Name:ACHI
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7217 ENCLAVE DR
Mailing Address - Street 2:
Mailing Address - City:EASTVALE
Mailing Address - State:CA
Mailing Address - Zip Code:92880-3827
Mailing Address - Country:US
Mailing Address - Phone:626-500-7250
Mailing Address - Fax:
Practice Address - Street 1:1655 N MOUNTAIN AVE STE 113
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91784-1779
Practice Address - Country:US
Practice Address - Phone:909-377-0030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-26
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95018334363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner