Basic Information
| Provider Information | |||||||||
| NPI: | 1356511687 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DANIOLCO | ||||||||
| FirstName: | CHERRY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | ACNP, CNS, MSN, RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8631 W 3RD ST | ||||||||
| Address2: | SUITE 800E | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900485901 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 8631 W 3RD ST | ||||||||
| Address2: | SUITE 800E | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900485901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3104235067 | ||||||||
| FaxNumber: | 3104230810 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/03/2008 | ||||||||
| LastUpdateDate: | 10/21/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 586113 | CA | N | Nursing Service Providers | Registered Nurse | 363LA2100X | 16962 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care | 364S00000X | 2650 | CA | N | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist |
No ID Information.