Healthcare Provider Details

I. General information

NPI: 1811231616
Provider Name (Legal Business Name): BIANCA SALVETTI N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2012
Last Update Date: 07/28/2022
Certification Date: 07/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4650 W SUNSET BLVD # 2
LOS ANGELES CA
90027-6062
US

IV. Provider business mailing address

4650 W SUNSET BLVD # 2
LOS ANGELES CA
90027-6062
US

V. Phone/Fax

Practice location:
  • Phone: 323-361-3103
  • Fax: 323-953-8116
Mailing address:
  • Phone: 323-361-2153
  • Fax: 323-953-8116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number19252
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code364SP0200X
TaxonomyPediatric Clinical Nurse Specialist
License Number3244
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number675937
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: