Healthcare Provider Details

I. General information

NPI: 1831612423
Provider Name (Legal Business Name): KAREN DACAYO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4024 DURFEE AVE
EL MONTE CA
91732-2510
US

IV. Provider business mailing address

4024 DURFEE AVE
EL MONTE CA
91732-2510
US

V. Phone/Fax

Practice location:
  • Phone: 626-450-8930
  • Fax: 626-450-8940
Mailing address:
  • Phone: 626-450-8930
  • Fax: 626-450-8940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number624680
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: