Provider Demographics
NPI:1578231031
Name:SARINO, EDNA (NP, FNP-C)
Entity Type:Individual
Prefix:
First Name:EDNA
Middle Name:
Last Name:SARINO
Suffix:
Gender:F
Credentials:NP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11856 BALBOA BLVD # 341
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-2753
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3203 E FLORENCE AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON PARK
Practice Address - State:CA
Practice Address - Zip Code:90255-5831
Practice Address - Country:US
Practice Address - Phone:323-835-6310
Practice Address - Fax:323-835-6382
Is Sole Proprietor?:No
Enumeration Date:2021-08-31
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95017692363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily