Healthcare Provider Details

I. General information

NPI: 1427873090
Provider Name (Legal Business Name): DANNA P MARTINEZ MARAVILLA MSW INTEM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/19/2024
Last Update Date: 11/19/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

THE WHOLE CHILD 10155 COLIMA ROAD
WHITTIER CA
90603
US

IV. Provider business mailing address

1085 E DORSET AVE
POMONA CA
91766-5504
US

V. Phone/Fax

Practice location:
  • Phone: 562-692-0383
  • Fax: 562-692-0380
Mailing address:
  • Phone: 805-458-1493
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: