MEDICARE: WEWIN FOR HEALTH

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
1	363LA2100X	Acute Care Nurse Practitioner	NP6891	CA

General Provider Information

NPI Number	:	1598054447
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEWIN FOR HEALTH

Provider Business Mailing Address
First Line	:	19015 TOWN CENTER DR STE 206
Second Line	:
City	:	APPLE VALLEY
State	:	CA
Zip	:	92308-8996
Country	:	US
Telephone Number	:	760-240-4729
Fax Number	:	760-240-2338

Provider Business Practice Location Address
First Line	:	17868 HWY 18 PMB 359
Second Line	:
City	:	APPLEVALLEY
State	:	CA
Zip	:	92307-1267
Country	:	US
Telephone Number	:	760-240-4729
Fax Number	:	760-240-2338

Authorized Official
Title or Position	:	PROGRAM DIRECTOR
Name	:	MR. SANDRA M STEWART
Credential	:	NP
Telephone Number	:	760-240-4729

Provider Enumeration Date	:	03/31/2011
Last Update Date	:	03/31/2011

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Directions to “WEWIN FOR HEALTH ” Practice Location

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