Provider Demographics
NPI:1275886277
Name:DONIS, KEILA
Entity Type:Individual
Prefix:
First Name:KEILA
Middle Name:
Last Name:DONIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6800 OWENSMOUTH AVE
Mailing Address - Street 2:SUITE 310
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91303-3159
Mailing Address - Country:US
Mailing Address - Phone:818-347-8565
Mailing Address - Fax:
Practice Address - Street 1:6800 OWENSMOUTH AVE
Practice Address - Street 2:SUITE 310
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91303-3159
Practice Address - Country:US
Practice Address - Phone:818-347-8565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-16
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator