Provider Demographics
NPI:1386177129
Name:WADZANI, DENIS (FNP-C, MPH)
Entity type:Individual
Prefix:
First Name:DENIS
Middle Name:
Last Name:WADZANI
Suffix:
Gender:M
Credentials:FNP-C, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 CORPORATE POINTE STE 270
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90230-8735
Mailing Address - Country:US
Mailing Address - Phone:424-266-7472
Mailing Address - Fax:
Practice Address - Street 1:5901 GREEN VALLEY CIR STE 405
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-6971
Practice Address - Country:US
Practice Address - Phone:424-266-7474
Practice Address - Fax:310-596-8268
Is Sole Proprietor?:No
Enumeration Date:2017-04-08
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95061349163W00000X
CA550753163WC1500X
CA95006189363L00000X, 363LP2300X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care