Provider Demographics
NPI:1053901090
Name:LAFAYETTE, DANIELLE J
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:J
Last Name:LAFAYETTE
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 1:6755 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90043-4407
Mailing Address - Country:US
Mailing Address - Phone:323-403-8112
Mailing Address - Fax:
Practice Address - Street 1:164 W 81ST ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90003-2428
Practice Address - Country:US
Practice Address - Phone:323-403-8112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-23
Last Update Date:2021-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator