Healthcare Provider Details

I. General information

NPI: 1548049471
Provider Name (Legal Business Name): ARIANA NEDDERMANN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2023
Last Update Date: 09/28/2023
Certification Date: 09/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11525 BROOKSHIRE AVE STE 202
DOWNEY CA
90241-4983
US

IV. Provider business mailing address

1101 N MAIN ST APT 413
LOS ANGELES CA
90012-4749
US

V. Phone/Fax

Practice location:
  • Phone: 562-869-1201
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP95024407
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: