Healthcare Provider Details

I. General information

NPI: 1851018741
Provider Name (Legal Business Name): NICHOLAS ANAYA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: NICO ANAYA

II. Dates (important events)

Enumeration Date: 10/21/2022
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7285 QUILL DR
DOWNEY CA
90242-2001
US

IV. Provider business mailing address

219 SPRINGFIELD AVE APT B
HUNTINGTON BEACH CA
92648-3139
US

V. Phone/Fax

Practice location:
  • Phone: 562-940-8681
  • Fax:
Mailing address:
  • Phone: 714-376-5976
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: