Provider Demographics
NPI:1477365880
Name:ARREDONDO, DANIELA (FNP)
Entity type:Individual
Prefix:
First Name:DANIELA
Middle Name:
Last Name:ARREDONDO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1148 ELISA DAWN DR
Mailing Address - Street 2:
Mailing Address - City:BANNING
Mailing Address - State:CA
Mailing Address - Zip Code:92220-1228
Mailing Address - Country:US
Mailing Address - Phone:909-964-7629
Mailing Address - Fax:
Practice Address - Street 1:9197 CENTRAL AVE STE H
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:CA
Practice Address - Zip Code:91763-1616
Practice Address - Country:US
Practice Address - Phone:909-827-0330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95033168363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily