Provider Demographics
NPI:1487208229
Name:JUAREZ, DANELLE
Entity Type:Individual
Prefix:
First Name:DANELLE
Middle Name:
Last Name:JUAREZ
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 1:21866 AMBAR DR
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-5205
Mailing Address - Country:US
Mailing Address - Phone:888-851-3677
Mailing Address - Fax:888-851-3671
Practice Address - Street 1:21866 AMBAR DR
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-5205
Practice Address - Country:US
Practice Address - Phone:888-851-3677
Practice Address - Fax:888-851-3671
Is Sole Proprietor?:No
Enumeration Date:2019-07-30
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156F00000XEye and Vision Services ProvidersTechnician/Technologist