Provider Demographics
NPI:1558119990
Name:SY, ANNE
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:SY
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 1:7725 GATEWAY UNIT 2209
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-5817
Mailing Address - Country:US
Mailing Address - Phone:657-243-5577
Mailing Address - Fax:
Practice Address - Street 1:13100 STUDEBAKER RD
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-2531
Practice Address - Country:US
Practice Address - Phone:855-464-2234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-10
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95162164163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult