Provider Demographics
NPI:1558184929
Name:ORDONEZ, DAISY ANGELICA
Entity type:Individual
Prefix:MISS
First Name:DAISY
Middle Name:ANGELICA
Last Name:ORDONEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9040 TOBIAS AVE APT 101
Mailing Address - Street 2:
Mailing Address - City:PANORAMA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91402-1734
Mailing Address - Country:US
Mailing Address - Phone:818-915-9639
Mailing Address - Fax:
Practice Address - Street 1:6400 LAUREL CANYON BLVD STE 500
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-1562
Practice Address - Country:US
Practice Address - Phone:818-901-6376
Practice Address - Fax:818-904-9273
Is Sole Proprietor?:No
Enumeration Date:2024-11-05
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner