Healthcare Provider Details

I. General information

NPI: 1982306338
Provider Name (Legal Business Name): ANA E. MALDONADO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3165 JOJOBA TER
PALMDALE CA
93550-8460
US

IV. Provider business mailing address

3165 JOJOBA TER
PALMDALE CA
93550-8460
US

V. Phone/Fax

Practice location:
  • Phone: 323-237-9432
  • Fax: 954-676-1198
Mailing address:
  • Phone: 323-237-9432
  • Fax: 954-676-1198

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN91500067
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95029874
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: