Healthcare Provider Details

I. General information

NPI: 1770085862
Provider Name (Legal Business Name): ANDREA ALMERAZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2018
Last Update Date: 03/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4156 S CENTRAL AVE
LOS ANGELES CA
90011-3154
US

IV. Provider business mailing address

115 E BROADWAY APT C201
SAN GABRIEL CA
91776-9182
US

V. Phone/Fax

Practice location:
  • Phone: 562-904-6031
  • Fax: 562-904-6033
Mailing address:
  • Phone: 626-617-1215
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number95008629
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: