Dontel D. Wise
Day Training/Habilitation Specialist in Grand Terrace, CA. Individual provider (NPI-1).
NPI number1316633019
StatusActive
Last updated in NPPESJan 14, 2026
Details
- NPI
- 1316633019
- Entity type
- Individual (NPI-1)
- Name
- Dontel D. Wise
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 14, 2023
- Certification date
- Jan 14, 2026
- Last updated
- Jan 14, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 373H00000X | Day Training/Habilitation Specialist | – | CA | Yes |
| 172V00000X | Community Health Worker | – | – |
Practice location
21935 Van Buren St Ste 13Grand Terrace, CA 92313-5624
Phone 909-906-1023
Mailing address
21935 Van Buren St Ste 1aGrand Terrace, CA 92313-5652
Phone 909-906-1023
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