MEDICARE: DHYANA LANDA RN, MSN

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	163WH0200X	Home Health Registered Nurse	95078094	CA

General Provider Information

NPI Number	:	1962133983
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DHYANA LANDA RN, MSN

Provider Business Mailing Address
First Line	:	3685 MOTOR AVE STE 100
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90034-5745
Country	:	US
Telephone Number	:	323-987-3736
Fax Number	:	323-800-5416

Provider Business Practice Location Address
First Line	:	3685 MOTOR AVE STE 100
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90034-5745
Country	:	US
Telephone Number	:	323-987-3736
Fax Number	:	323-800-5416

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

Provider Enumeration Date	:	06/21/2022
Last Update Date	:	06/04/2025

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