Provider Demographics
NPI:1902933872
Name:SERRANO, ANNA MELINDA (NP)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:MELINDA
Last Name:SERRANO
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 1:3743 S LA BREA AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90016-5309
Mailing Address - Country:US
Mailing Address - Phone:323-329-9925
Mailing Address - Fax:323-294-3949
Practice Address - Street 1:3743 S LA BREA AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90016-5309
Practice Address - Country:US
Practice Address - Phone:323-329-9925
Practice Address - Fax:323-294-3949
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2015-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA432536363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner