Provider Demographics
NPI:1376825489
Name:NEWTON, DANIELLE DOLORES (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:DOLORES
Last Name:NEWTON
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:DOLORES
Other - Last Name:THISSELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:2195 CLUB CENTER DR
Mailing Address - Street 2:SUITE G
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92408-4170
Mailing Address - Country:US
Mailing Address - Phone:925-980-8374
Mailing Address - Fax:909-835-1858
Practice Address - Street 1:2195 CLUB CENTER DR
Practice Address - Street 2:SUITE G
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-4170
Practice Address - Country:US
Practice Address - Phone:925-980-8374
Practice Address - Fax:909-835-1858
Is Sole Proprietor?:No
Enumeration Date:2011-09-14
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7168235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist