Provider Demographics
NPI:1902050867
Name:SARAVIA, ANNA NINNETTE (MSPA-C)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:NINNETTE
Last Name:SARAVIA
Suffix:
Gender:F
Credentials:MSPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 E AMAR RD
Mailing Address - Street 2:163
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91792-1741
Mailing Address - Country:US
Mailing Address - Phone:626-667-7424
Mailing Address - Fax:626-667-7424
Practice Address - Street 1:7777 MILLIKEN AVE STE A
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-7489
Practice Address - Country:US
Practice Address - Phone:909-948-8050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-05
Last Update Date:2009-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA19970363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical