Provider Demographics
NPI:1881903797
Name:CARCHI, ANNA (DNP, ACNP)
Entity type:Individual
Prefix:DR
First Name:ANNA
Middle Name:
Last Name:CARCHI
Suffix:
Gender:F
Credentials:DNP, ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 E HARDY ST
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90301-4011
Mailing Address - Country:US
Mailing Address - Phone:310-295-0075
Mailing Address - Fax:310-295-0062
Practice Address - Street 1:555 E HARDY ST
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-4011
Practice Address - Country:US
Practice Address - Phone:310-295-0075
Practice Address - Fax:310-295-0062
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-28
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20168363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFT332AMedicare PIN
CA1902846306OtherGROUP NPI
CAGR0100430OtherGROUP MEDI-CAL