Healthcare Provider Details

I. General information

NPI: 1780178392
Provider Name (Legal Business Name): INGRY T VO APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2018
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2237 W BALL RD
ANAHEIM CA
92804-5314
US

IV. Provider business mailing address

PO BOX 81064
RANCHO SANTA MARGARITA CA
92688-8164
US

V. Phone/Fax

Practice location:
  • Phone: 714-490-2750
  • Fax: 714-490-2757
Mailing address:
  • Phone: 772-618-3771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN9293975
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN9293975
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95020491
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: