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NPI Code Detail

MEDICARE: NICOLE DANELLE CAMPOS

MEDICARE: NICOLE DANELLE CAMPOS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1172V00000XCommunity Health WorkerD6838870CA

General Provider Information

NPI Number : 1730673393
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE DANELLE CAMPOS
Provider Business Mailing Address
First Line : 1133 E RHEA ST
Second Line :
City : LONG BEACH
State : CA
Zip : 90806-5125
Country : US
Telephone Number : 562-570-4402
Fax Number :
Provider Business Practice Location Address
First Line : 1133 E RHEA ST
Second Line :
City : LONG BEACH
State : CA
Zip : 90806-5125
Country : US
Telephone Number : 562-570-4402
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2018
Last Update Date : 06/18/2018

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Directions to “ NICOLE DANELLE CAMPOS ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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