Most Relevant Information
Provider Data
| NPI Number: | 1003657610 |
| Provider Name: | KEANNA GISELLE AQUINO |
| Entity Type: | Individual |
| Taxonomy Code: | 172V00000X |
| Specialty: | Community Health Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/06/2024 |
| Last Updated: | 06/06/2024 |
Provider Practice Location
1801 HUNTINGTON DR
DUARTE
CA
910102635
Practice Location Phone/Fax
| Phone: | 6269933000 |
| Fax: |
Provider Mailing Location
1801 HUNTINGTON DR
DUARTE
CA
910102635
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |