Healthcare Provider Details

I. General information

NPI: 1881607166
Provider Name (Legal Business Name): ANNETTE HELENA ANDERSON DNP, FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1030 E FLORIDA AVE
HEMET CA
92543-4511
US

IV. Provider business mailing address

215 S HICKORY ST
ESCONDIDO CA
92025-4359
US

V. Phone/Fax

Practice location:
  • Phone: 833-867-4642
  • Fax: 760-741-2782
Mailing address:
  • Phone: 833-867-4642
  • Fax: 760-741-2782

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN561724
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number13109
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: