Healthcare Provider Details

I. General information

NPI: 1376472316
Provider Name (Legal Business Name): DANIELA ACEVEDO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27740 JEFFERSON AVE
TEMECULA CA
92590-2698
US

IV. Provider business mailing address

27740 JEFFERSON AVE
TEMECULA CA
92590-2698
US

V. Phone/Fax

Practice location:
  • Phone: 951-252-8800
  • Fax: 951-252-8801
Mailing address:
  • Phone: 951-252-8800
  • Fax: 951-252-8801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number32936
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: