Provider Demographics
NPI:1720396187
Name:LANDIN, ANITA M
Entity Type:Individual
Prefix:MS
First Name:ANITA
Middle Name:M
Last Name:LANDIN
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 1:5650 E AVENUE R11
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93552-4690
Mailing Address - Country:US
Mailing Address - Phone:661-349-1867
Mailing Address - Fax:
Practice Address - Street 1:1609 E PALMDALE BLVD STE G
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93550-4881
Practice Address - Country:US
Practice Address - Phone:661-947-1595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-20
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management