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General NPI Number Information
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NPI Number | 1245778430
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Entity Type | Individual
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Provider Name | ANNE DELGADO
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Gender | Female
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Dates
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Enumeration Date | 02/07/2017
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Last Update Date | 02/10/2017
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Provider Practice Location Address
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Address Line | 18700 OXNARD ST
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City | TARZANA
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State | CA
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Zip | 91356-1413
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Country | US
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Telephone | 818-996-1051
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Fax |
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Provider Business Mailing Address
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Address Line | 11357 COMETA AVE
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City | PACOIMA
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State | CA
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Zip | 91331-1402
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Country | US
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Telephone | 818-792-1079
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number | D3092722
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License Number State | CA
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