Provider Demographics
NPI:1194574129
Name:DANIELS, ANNA KATELYN (FNP)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:KATELYN
Last Name:DANIELS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:ANNA
Other - Middle Name:KATELYN
Other - Last Name:DANEILS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:15021 VENTURA BLVD # 883
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-2442
Mailing Address - Country:US
Mailing Address - Phone:703-999-3947
Mailing Address - Fax:
Practice Address - Street 1:7300 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-1902
Practice Address - Country:US
Practice Address - Phone:818-676-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-13
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95029828363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner