Healthcare Provider Details

I. General information

NPI: 1225916265
Provider Name (Legal Business Name): DANIELLE MONIQUE WEST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2025
Last Update Date: 10/11/2025
Certification Date: 10/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12917 CERISE AVE
HAWTHORNE CA
90250-5520
US

IV. Provider business mailing address

12917 CERISE AVE
HAWTHORNE CA
90250-5520
US

V. Phone/Fax

Practice location:
  • Phone: 310-675-4431
  • Fax: 310-675-4434
Mailing address:
  • Phone: 310-675-4431
  • Fax: 310-675-4434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number1225916265
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: