Healthcare Provider Details

I. General information

NPI: 1922008556
Provider Name (Legal Business Name): WENDI ROSENBLATT RNC, NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2005
Last Update Date: 03/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 SOUTH TUSTIN STREET
ORANGE CA
92866
US

IV. Provider business mailing address

700 S TUSTIN ST
ORANGE CA
92866-3425
US

V. Phone/Fax

Practice location:
  • Phone: 714-633-6373
  • Fax:
Mailing address:
  • Phone: 714-633-6373
  • Fax: 714-657-0657

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberRN362233 NP6082
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: