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General NPI Number Information
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NPI Number | 1750508735
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Entity Type | Organization
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Legal Business Name | WOMEN'S HEALTHCAE CONNECTION
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 08/08/2007
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Provider Practice Location Address
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Address Line | 7111 WINNETKA AVE # 6
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City | CANOGA PARK
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State | CA
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Zip | 91306-3646
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Country | US
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Telephone | 818-587-9200
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Fax | 818-587-9201
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Provider Business Mailing Address
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Address Line | 7111 WINNETKA AVE # 6
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City | CANOGA PARK
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State | CA
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Zip | 91306-3646
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Country | US
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Telephone | 818-587-9200
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Fax | 818-587-9201
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Authorized Official
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Title or Position | PROVIDER
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Name | INAS ANIS
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Credential | NURSE PRACTITIONER
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Telephone | 818-587-9200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LX0001X
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Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
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License Number | RN461744 8797
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License Number State | CA
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