Provider Demographics
NPI:1497389365
Name:WARLICK-BROWN, SAMANTHA YVETTE
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:YVETTE
Last Name:WARLICK-BROWN
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 1:23130 SHERMAN PL UNIT 602
Mailing Address - Street 2:
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91307-2055
Mailing Address - Country:US
Mailing Address - Phone:818-376-9087
Mailing Address - Fax:
Practice Address - Street 1:23130 SHERMAN PL UNIT 602
Practice Address - Street 2:
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-2055
Practice Address - Country:US
Practice Address - Phone:818-376-9087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-28
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA181273164X00000X, 164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No164X00000XNursing Service ProvidersLicensed Vocational Nurse