Provider Demographics
NPI:1164812293
Name:HAMID, WAHIDA NADI (FNP)
Entity Type:Individual
Prefix:
First Name:WAHIDA
Middle Name:NADI
Last Name:HAMID
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4535 70TH ST
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-0701
Mailing Address - Country:US
Mailing Address - Phone:619-609-9294
Mailing Address - Fax:619-720-2112
Practice Address - Street 1:4535 70TH ST
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-0701
Practice Address - Country:US
Practice Address - Phone:619-609-9492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-27
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95001707363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner