Provider Demographics
NPI:1528228483
Name:NASH, WILMA JOAN
Entity Type:Individual
Prefix:
First Name:WILMA
Middle Name:JOAN
Last Name:NASH
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 1:1033 N HOLLYWOOD WAY
Mailing Address - Street 2:UNIT F
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-2540
Mailing Address - Country:US
Mailing Address - Phone:818-239-0112
Mailing Address - Fax:818-239-0244
Practice Address - Street 1:5724 W 3RD ST
Practice Address - Street 2:#307
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-3078
Practice Address - Country:US
Practice Address - Phone:323-456-0801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-13
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator