Individual
DANILLE P IJOMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
233 BASE LINE RD, LA VERNE, CA 91750-2353
(909) 593-2581
Mailing address
233 BASE LINE RD, LA VERNE, CA 91750-2353
(909) 593-2581
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
195295
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7565A
OUT PATIENT MENTAL HEALTH
CA
Enumeration date
03/29/2007
Last updated
07/08/2007
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