Provider Demographics
NPI:1538031133
Name:PENA-DANNENBRING, LEEYANA ANGELICA (LSW)
Entity type:Individual
Prefix:
First Name:LEEYANA
Middle Name:ANGELICA
Last Name:PENA-DANNENBRING
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3680 N RANCHO DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-3180
Mailing Address - Country:US
Mailing Address - Phone:702-646-5437
Mailing Address - Fax:702-396-4913
Practice Address - Street 1:3680 N RANCHO DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-3180
Practice Address - Country:US
Practice Address - Phone:702-646-5437
Practice Address - Fax:702-396-4913
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-22
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Single Specialty