1558379990 NPI number — COUNTY OF LOS ANGELES

Table of content: MRS. DANIELLE REBECCA NEWTON M.S., N.C.C. (NPI 1316389216)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558379990 NPI number — COUNTY OF LOS ANGELES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNTY OF LOS ANGELES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1558379990
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/18/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1212 PICO ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN FERNANDO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91340-3503
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-627-3050
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1212 PICO ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN FERNANDO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91340-3503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-627-3050
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
O'BRIEN
Authorized Official First Name:
QUENTIN
Authorized Official Middle Name:
Authorized Official Title or Position:
AMBULATORY NETWORK, CEO
Authorized Official Telephone Number:
213-288-9000

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: FHC16080F , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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