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NPI Code Detail

MEDICARE: DANIELLE SHERIE CARR

MEDICARE: DANIELLE SHERIE CARR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst
2172V00000XCommunity Health Worker
3175T00000XPeer SpecialistCA

General Provider Information

NPI Number : 1033702634
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELLE SHERIE CARR
Provider Business Mailing Address
First Line : 3186 AIRWAY AVE STE A
Second Line :
City : COSTA MESA
State : CA
Zip : 92626-4650
Country : US
Telephone Number : 714-881-0427
Fax Number : 714-327-0673
Provider Business Practice Location Address
First Line : 5400 KEARNY MESA RD
Second Line :
City : SAN DIEGO
State : CA
Zip : 92111-1303
Country : US
Telephone Number : 619-717-2363
Fax Number : 714-327-0673
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2021
Last Update Date : 11/13/2024

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Directions to “ DANIELLE SHERIE CARR ” Practice Location

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