MEDICARE: MRS. JANINA SALTIS NURSE PRACTITIONER

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	570107	CA

General Provider Information

NPI Number	:	1528188117
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JANINA SALTIS NURSE PRACTITIONER

Provider Business Mailing Address
First Line	:	1127 MANZANITA ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90029-2231
Country	:	US
Telephone Number	:	323-663-5056
Fax Number	:	323-783-5293

Provider Business Practice Location Address
First Line	:	11645 WILSHIRE BLVD STE 1155
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-6807
Country	:	US
Telephone Number	:	310-966-9022
Fax Number	:	310-966-9042

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

Provider Enumeration Date	:	03/29/2007
Last Update Date	:	12/06/2021

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