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General NPI Number Information
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NPI Number | 1316277171
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Entity Type | Organization
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Legal Business Name | VITALE
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Dates
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Enumeration Date | 12/30/2009
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Last Update Date | 12/30/2009
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Provider Practice Location Address
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Address Line | 1118 11TH ST STE. 6
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City | SANTA MONICA
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State | CA
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Zip | 90403-5318
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Country | US
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Telephone | 310-795-5854
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Fax | 323-766-1103
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Provider Business Mailing Address
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Address Line | 1118 11TH ST STE. 6
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City | SANTA MONICA
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State | CA
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Zip | 90403-5318
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Country | US
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Telephone | 310-795-5854
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Fax | 323-766-1103
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. JULIE MARIE WOZNIAK
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Credential | R.N.
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Telephone | 310-795-5854
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number | RN680091
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN680091
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License Number State | CA
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