Provider Demographics
NPI:1447563416
Name:HORNE, DELESHIA (MA)
Entity type:Individual
Prefix:
First Name:DELESHIA
Middle Name:
Last Name:HORNE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 TECHNOLOGY CT
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92507-2155
Mailing Address - Country:US
Mailing Address - Phone:951-688-8500
Mailing Address - Fax:
Practice Address - Street 1:555 TECHNOLOGY CT
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507
Practice Address - Country:US
Practice Address - Phone:951-686-8500
Practice Address - Fax:951-369-3037
Is Sole Proprietor?:No
Enumeration Date:2010-07-20
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker