Healthcare Provider Details

I. General information

NPI: 1265981088
Provider Name (Legal Business Name): DANIELLE SCALA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2016
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date: 08/22/2023
Reactivation Date: 09/01/2023

III. Provider practice location address

1391 W 132ND PL
WESTMINSTER CO
80234-1195
US

IV. Provider business mailing address

1391 W 132ND PL
WESTMINSTER CO
80234-1195
US

V. Phone/Fax

Practice location:
  • Phone: 541-227-4750
  • Fax: 541-325-4826
Mailing address:
  • Phone: 541-227-4750
  • Fax: 541-325-4826

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1690860
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0998948
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: