Provider Demographics
NPI:1801214804
Name:ORNELAZ-PEREZ, DENICE
Entity Type:Individual
Prefix:
First Name:DENICE
Middle Name:
Last Name:ORNELAZ-PEREZ
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 1:5873 NOELS KNOLL RD
Mailing Address - Street 2:
Mailing Address - City:TWENTYNINE PALMS
Mailing Address - State:CA
Mailing Address - Zip Code:92277-4031
Mailing Address - Country:US
Mailing Address - Phone:619-987-6770
Mailing Address - Fax:
Practice Address - Street 1:5873 NOELS KNOLL RD
Practice Address - Street 2:
Practice Address - City:TWENTYNINE PALMS
Practice Address - State:CA
Practice Address - Zip Code:92277-4031
Practice Address - Country:US
Practice Address - Phone:619-987-6770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-07
Last Update Date:2014-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10045374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula