Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 22066 | CA |
NPI | 1174987754 |
---|---|
Provider Name | Anali Vera |
First Address | San Diego, CA 92108-2505 |
Second Address | San Diego, CA 92103-9000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2016 |
Last Update Date | 08/04/2016 |