Healthcare Provider Details

I. General information

NPI: 1548172844
Provider Name (Legal Business Name): SAINT VERENA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

1491 STEIN STRAUSS ST
FULLERTON CA
92833-2159
US

IV. Provider business mailing address

1491 STEIN STRAUSS ST
FULLERTON CA
92833-2159
US

V. Phone/Fax

Practice location:
  • Phone: 562-293-6000
  • Fax: 657-500-8383
Mailing address:
  • Phone: 562-293-6000
  • Fax: 657-500-8383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0600X
TaxonomyGerontology Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: MRS. AMPARO FERNANDEZ WANG
Title or Position: C.E.O./ADMINISTRATOR
Credential: LVN
Phone: 562-293-6000