Provider Demographics
NPI:1386441038
Name:ALLEN, DANIEL (RN, PHN)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:ALLEN
Suffix:
Gender:
Credentials:RN, PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1124 S CHAPEL AVE
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-4827
Mailing Address - Country:US
Mailing Address - Phone:213-290-1231
Mailing Address - Fax:
Practice Address - Street 1:1124 S CHAPEL AVE
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-4827
Practice Address - Country:US
Practice Address - Phone:213-290-1231
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-28
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA71751163WC1500X
CA576072163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health