Healthcare Provider Details

I. General information

NPI: 1689379554
Provider Name (Legal Business Name): SAVANNAH L SALWEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2023
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45280 SEELEY DR
LA QUINTA CA
92253-6834
US

IV. Provider business mailing address

45280 SEELEY DR
LA QUINTA CA
92253-6834
US

V. Phone/Fax

Practice location:
  • Phone: 760-610-7300
  • Fax: 760-610-7301
Mailing address:
  • Phone: 760-610-7300
  • Fax: 760-610-7301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95031294
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: