Provider Demographics
NPI:1598432320
Name:GULRAIZ, ANAM (PMHNP-BC)
Entity type:Individual
Prefix:MS
First Name:ANAM
Middle Name:
Last Name:GULRAIZ
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 BAYVIEW CIR STE 104
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2948
Mailing Address - Country:US
Mailing Address - Phone:310-926-5723
Mailing Address - Fax:714-475-3716
Practice Address - Street 1:3420 BRISTOL ST FL 6
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-7170
Practice Address - Country:US
Practice Address - Phone:714-386-9766
Practice Address - Fax:714-475-3716
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-28
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95017542363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty