Provider Demographics
NPI:1861811788
Name:DELA CRUZ, ANNE JANETTE GARDUCE (NP)
Entity type:Individual
Prefix:MISS
First Name:ANNE JANETTE
Middle Name:GARDUCE
Last Name:DELA CRUZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:ANNE JANETTE
Other - Middle Name:
Other - Last Name:VELASQUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1260 N KENMORE AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90029-1506
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:127 S SAN VICENTE BLVD
Practice Address - Street 2:A-3600
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048
Practice Address - Country:US
Practice Address - Phone:310-423-1735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-08
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95000332363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care