Provider Demographics
NPI:1821247578
Name:PADILLA, DENISE H
Entity Type:Individual
Prefix:MISS
First Name:DENISE
Middle Name:H
Last Name:PADILLA
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 1:750 E 5TH ST UNIT 6
Mailing Address - Street 2:
Mailing Address - City:AZUSA
Mailing Address - State:CA
Mailing Address - Zip Code:91702-3876
Mailing Address - Country:US
Mailing Address - Phone:415-812-3240
Mailing Address - Fax:
Practice Address - Street 1:750 E 5TH ST UNIT 6
Practice Address - Street 2:
Practice Address - City:AZUSA
Practice Address - State:CA
Practice Address - Zip Code:91702-3876
Practice Address - Country:US
Practice Address - Phone:415-812-3240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-17
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health