Provider Demographics
NPI:1528188117
Name:SALTIS, JANINA (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MRS
First Name:JANINA
Middle Name:
Last Name:SALTIS
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 1:1127 MANZANITA ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90029-2231
Mailing Address - Country:US
Mailing Address - Phone:323-663-5056
Mailing Address - Fax:323-783-5293
Practice Address - Street 1:11645 WILSHIRE BLVD STE 1155
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-6807
Practice Address - Country:US
Practice Address - Phone:310-966-9022
Practice Address - Fax:310-966-9042
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA570107363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily