Provider Demographics
NPI:1871948133
Name:ANASIS, MARIA (NP)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:ANASIS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3432 E WHITE CHAPEL CT
Mailing Address - Street 2:UNIT A
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92869-7518
Mailing Address - Country:US
Mailing Address - Phone:714-904-5732
Mailing Address - Fax:
Practice Address - Street 1:3432 E WHITE CHAPEL CT
Practice Address - Street 2:UNIT A
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92869-7518
Practice Address - Country:US
Practice Address - Phone:714-904-5732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-24
Last Update Date:2016-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95001923363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health