Healthcare Provider Details

I. General information

NPI: 1043853732
Provider Name (Legal Business Name): GRAMMY HUAYHUA FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2019
Last Update Date: 05/05/2022
Certification Date: 05/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19503 BLUFFWOOD ST
ROWLAND HEIGHTS CA
91748-2413
US

IV. Provider business mailing address

19503 BLUFFWOOD ST
ROWLAND HEIGHTS CA
91748-2413
US

V. Phone/Fax

Practice location:
  • Phone: 951-295-1802
  • Fax:
Mailing address:
  • Phone: 951-295-1802
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP95011255
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: