Provider Demographics
NPI:1346070240
Name:WEBER, GERALDINE ANN (FNP)
Entity type:Individual
Prefix:PROF
First Name:GERALDINE
Middle Name:ANN
Last Name:WEBER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5001 REYNARD AVE
Mailing Address - Street 2:
Mailing Address - City:LA CRESCENTA
Mailing Address - State:CA
Mailing Address - Zip Code:91214-1047
Mailing Address - Country:US
Mailing Address - Phone:310-666-5221
Mailing Address - Fax:310-909-9747
Practice Address - Street 1:1051 GLENDON AVE # 112
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-2907
Practice Address - Country:US
Practice Address - Phone:310-909-9747
Practice Address - Fax:310-909-9747
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-05
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA13249363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily