Provider Demographics
NPI:1215306576
Name:ARMENTA, ANA GUADALUPE
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:GUADALUPE
Last Name:ARMENTA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 CALDECOTT LN
Mailing Address - Street 2:UNIT 209
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94618-2410
Mailing Address - Country:US
Mailing Address - Phone:805-456-9998
Mailing Address - Fax:
Practice Address - Street 1:757 WESTWOOD PLZ STE 660
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-8358
Practice Address - Country:US
Practice Address - Phone:310-206-6158
Practice Address - Fax:310-825-2236
Is Sole Proprietor?:No
Enumeration Date:2015-09-16
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA706313163W00000X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse