Healthcare Provider Details

I. General information

NPI: 1467582692
Provider Name (Legal Business Name): MS. NOEMI CRISTINA HARNEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 S DE LACEY AVE STE 110
PASADENA CA
91105-2074
US

IV. Provider business mailing address

9540 CAMULOS AVE
MONTCLAIR CA
91763-2222
US

V. Phone/Fax

Practice location:
  • Phone: 626-395-7100
  • Fax: 626-403-6532
Mailing address:
  • Phone: 909-621-7101
  • Fax: 626-403-6532

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: