Basic Information
| Provider Information | |||||||||
| NPI: | 1053946780 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CAUSOR | ||||||||
| FirstName: | DANISSA | ||||||||
| MiddleName: | |||||||||
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| Credential: | |||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | CAUSOR | ||||||||
| OtherFirstName: | DANISSA | ||||||||
| OtherMiddleName: | |||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 287 RIO LINDO AVE | ||||||||
| Address2: | |||||||||
| City: | CHICO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 959261973 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5308934784 | ||||||||
| FaxNumber: | 5308936144 | ||||||||
| Practice Location | |||||||||
| Address1: | 287 RIO LINDO AVE | ||||||||
| Address2: | |||||||||
| City: | CHICO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 959261973 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5308934784 | ||||||||
| FaxNumber: | 5308936144 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/03/2020 | ||||||||
| LastUpdateDate: | 03/03/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/03/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 373H00000X | Y | Nursing Service Related Providers | Day Training/Habilitation Specialist |
No ID Information.