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General NPI Number Information
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NPI Number | 1477156982
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Entity Type | Individual
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Provider Name | ANITA WOLF FNP
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Gender | Female
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Dates
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Enumeration Date | 11/17/2020
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Last Update Date | 04/11/2025
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Provider Practice Location Address
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Address Line | 6405 DAY ST
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City | RIVERSIDE
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State | CA
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Zip | 92507-0901
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Country | US
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Telephone | 951-697-5405
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Fax | 951-697-5687
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Provider Business Mailing Address
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Address Line | 6405 DAY ST
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City | RIVERSIDE
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State | CA
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Zip | 92507-0901
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Country | US
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Telephone | 951-697-5405
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Fax | 951-697-5687
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95017385
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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 | 546486
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 163WD0400X
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Taxonomy Name | Diabetes Educator Registered Nurse
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License Number | 21800115
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 95045423
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License Number State | CA
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