Provider Demographics
NPI:1467143438
Name:UY, JOEL ANDARZA (FNP-BC)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:ANDARZA
Last Name:UY
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15910 VENTURA BLVD STE 1728
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2838
Mailing Address - Country:US
Mailing Address - Phone:310-278-9171
Mailing Address - Fax:
Practice Address - Street 1:15910 VENTURA BLVD STE 1728
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2838
Practice Address - Country:US
Practice Address - Phone:310-278-9171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-18
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95021501363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily