Provider Demographics
NPI:1699510651
Name:SALAZAR, ANNA MARIA L (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:ANNA MARIA
Middle Name:L
Last Name:SALAZAR
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:329 PARKSIDE CT
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93927-5035
Mailing Address - Country:US
Mailing Address - Phone:831-776-6863
Mailing Address - Fax:
Practice Address - Street 1:329 PARKSIDE CT
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:CA
Practice Address - Zip Code:93927-5035
Practice Address - Country:US
Practice Address - Phone:831-776-6863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-01
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95030816363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily