Healthcare Provider Details

I. General information

NPI: 1134759376
Provider Name (Legal Business Name): ANNA VUE FNP, PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2020
Last Update Date: 12/13/2024
Certification Date: 12/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9343 TECH CENTER DR STE 110
SACRAMENTO CA
95826-2592
US

IV. Provider business mailing address

18225 HALE AVE
MORGAN HILL CA
95037-3547
US

V. Phone/Fax

Practice location:
  • Phone: 408-465-8280
  • Fax:
Mailing address:
  • Phone: 408-465-8280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95012482
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95012482
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: