Provider Demographics
NPI:1023257052
Name:HARRIS-NGUYEN, DANIELLE BROOKE (MA, OTR/L)
Entity type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:BROOKE
Last Name:HARRIS-NGUYEN
Suffix:
Gender:F
Credentials:MA, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:24361 EL TORO RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:LAGUNA WOODS
Mailing Address - State:CA
Mailing Address - Zip Code:92637-2755
Mailing Address - Country:US
Mailing Address - Phone:949-458-2040
Mailing Address - Fax:949-458-2064
Practice Address - Street 1:24361 EL TORO RD
Practice Address - Street 2:SUITE 108
Practice Address - City:LAGUNA WOODS
Practice Address - State:CA
Practice Address - Zip Code:92637-2755
Practice Address - Country:US
Practice Address - Phone:949-458-2040
Practice Address - Fax:949-458-2064
Is Sole Proprietor?:No
Enumeration Date:2009-02-15
Last Update Date:2009-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 7740225XL0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XL0004XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistLow Vision