Provider Demographics
NPI:1437885837
Name:ALVAREZ, NANCY ANDA (NP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:ANDA
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:723 BRIAR HILL CIR
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-6004
Mailing Address - Country:US
Mailing Address - Phone:818-448-4366
Mailing Address - Fax:
Practice Address - Street 1:723 BRIAR HILL CIR
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-6004
Practice Address - Country:US
Practice Address - Phone:818-448-4366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-27
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95021578207QG0300X
CANPF95021578363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine