Healthcare Provider Details

I. General information

NPI: 1265368427
Provider Name (Legal Business Name): SALENA BIRDSALL NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

999 N TUSTIN AVE STE 224
SANTA ANA CA
92705-6506
US

IV. Provider business mailing address

999 N TUSTIN AVE STE 224
SANTA ANA CA
92705-6506
US

V. Phone/Fax

Practice location:
  • Phone: 714-664-0045
  • Fax: 714-664-0049
Mailing address:
  • Phone: 714-664-0045
  • Fax: 714-664-0049

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP95039782
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: