Individual
DONNISE FENNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1045 W REDONDO BEACH BLVD, GARDENA, CA 90247-4128
(310) 689-9699
(310) 689-9699
Mailing address
1501 HUGHES WAY, SUITE 150, LONG BEACH, CA 90810-1876
(310) 221-6336
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
172V00000X
Community Health Worker
Primary
—
—
225400000X
Rehabilitation Practitioner
—
—
Other
Enumeration date
03/30/2017
Last updated
04/25/2025
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