Healthcare Provider Details

I. General information

NPI: 1447177969
Provider Name (Legal Business Name): ANNIE KOIRALA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45388 WILLOWICK ST
TEMECULA CA
92592-1379
US

IV. Provider business mailing address

45388 WILLOWICK ST
TEMECULA CA
92592-1379
US

V. Phone/Fax

Practice location:
  • Phone: 970-286-8717
  • Fax:
Mailing address:
  • Phone: 970-286-8717
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number840153
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: