Healthcare Provider Details

I. General information

NPI: 1093507469
Provider Name (Legal Business Name): ANNIKA WURM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2025
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15200 FOOTHILL BLVD
CASTRO VALLEY CA
94578-1013
US

IV. Provider business mailing address

10100 TORRE AVE APT 147
CUPERTINO CA
95014-2165
US

V. Phone/Fax

Practice location:
  • Phone: 510-352-9690
  • Fax:
Mailing address:
  • Phone: 704-779-7467
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: