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NPI Code Detail

MEDICARE: JULIE ANN THERESE PEFIANCO DE LOS SANTOS NP

MEDICARE: JULIE ANN THERESE PEFIANCO DE LOS SANTOS NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WG0000XGeneral Practice Registered Nurse95248205CA
2363LP0808XPsychiatric/Mental Health Nurse PractitionerNP95032208CA

General Provider Information

NPI Number : 1194541839
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIE ANN THERESE PEFIANCO DE LOS SANTOS NP
Provider Business Mailing Address
First Line : 1849 SAWTELLE BLVD STE 610
Second Line :
City : LOS ANGELES
State : CA
Zip : 90025-7013
Country : US
Telephone Number : 530-691-0194
Fax Number : 310-943-2321
Provider Business Practice Location Address
First Line : 1849 SAWTELLE BLVD STE 610
Second Line :
City : LOS ANGELES
State : CA
Zip : 90025-7013
Country : US
Telephone Number : 310-691-0194
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/26/2024
Last Update Date : 04/24/2026

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Directions to “ JULIE ANN THERESE PEFIANCO DE LOS SANTOS NP” Practice Location

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