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General NPI Number Information
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NPI Number | 1487297107
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Entity Type | Individual
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Provider Name | FAREEHA SIPRA NURSE PRACTIONER
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Gender | Female
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Dates
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Enumeration Date | 10/25/2019
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Last Update Date | 05/31/2024
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Provider Practice Location Address
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Address Line | 2029 CENTURY PARK E STE 400
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City | LOS ANGELES
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State | CA
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Zip | 90067-2905
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Country | US
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Telephone | 559-259-2478
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Fax |
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Provider Business Mailing Address
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Address Line | 1225 M ST
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City | FRESNO
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State | CA
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Zip | 93721-1805
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Country | US
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Telephone | 559-600-9360
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 95013049
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License Number State | CA
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