MEDICARE: EMIOLA SANNI NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	AC007297	MD
2	363LF0000X	Family Nurse Practitioner	SP031769	PA
3	363LF0000X	Family Nurse Practitioner	322526	AZ
4	363LF0000X	Family Nurse Practitioner	30045	SC
5	363LF0000X	Family Nurse Practitioner	240294	LA
6	363LF0000X	Family Nurse Practitioner	5022170	NC
7	363LF0000X	Family Nurse Practitioner	RN10023967	MA
8	363LF0000X	Family Nurse Practitioner	A182086	IA
9	363LF0000X	Family Nurse Practitioner	AP130849	TX

General Provider Information

NPI Number	:	1003264755
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMIOLA SANNI NP

Provider Business Mailing Address
First Line	:	12900 PARK PLAZA DR STE 150
Second Line	:
City	:	CERRITOS
State	:	CA
Zip	:	90703-9329
Country	:	US
Telephone Number	:	562-741-4479
Fax Number	:

Provider Business Practice Location Address
First Line	:	3800 BUFFALO SPEEDWAY STE 400
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-3706
Country	:	US
Telephone Number	:	281-455-1758
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2016
Last Update Date	:	08/05/2025

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Directions to “ EMIOLA SANNI NP” Practice Location

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