Healthcare Provider Details

I. General information

NPI: 1184400905
Provider Name (Legal Business Name): WINNIE HUANG APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2023
Last Update Date: 11/26/2025
Certification Date: 11/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1225 WILSHIRE BLVD
LOS ANGELES CA
90017-1901
US

IV. Provider business mailing address

744 S FIGUEROA ST APT 605
LOS ANGELES CA
90017-4820
US

V. Phone/Fax

Practice location:
  • Phone: 305-509-0962
  • Fax:
Mailing address:
  • Phone: 305-509-0962
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number9620285
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9620285
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95036920
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: