Healthcare Provider Details

I. General information

NPI: 1447611785
Provider Name (Legal Business Name): WENDY ANN SILVA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2016
Last Update Date: 03/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

808 W 58TH ST
LOS ANGELES CA
90037-3632
US

IV. Provider business mailing address

6551 WARNER AVE APT 52
HUNTINGTON BEACH CA
92647-5249
US

V. Phone/Fax

Practice location:
  • Phone: 760-504-9625
  • Fax:
Mailing address:
  • Phone: 760-504-9625
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number613376
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code364SN0000X
TaxonomyNeonatal Clinical Nurse Specialist
License Number4078
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberNP95003769
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: