Healthcare Provider Details

I. General information

NPI: 1871400846
Provider Name (Legal Business Name): DANIELLE THERESE CO TY MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3858 W CARSON ST STE 100
TORRANCE CA
90503-6705
US

IV. Provider business mailing address

5474 BARELA AVE
TEMPLE CITY CA
91780-3209
US

V. Phone/Fax

Practice location:
  • Phone: 424-225-1481
  • Fax:
Mailing address:
  • Phone: 626-510-2015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: