Provider Demographics
NPI:1003508607
Name:SERAY-WURIE, NADIA MARCELLA (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:NADIA
Middle Name:MARCELLA
Last Name:SERAY-WURIE
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5757 W CENTURY BLVD FL 6
Mailing Address - Street 2:STE 650R
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-6401
Mailing Address - Country:US
Mailing Address - Phone:888-680-0863
Mailing Address - Fax:
Practice Address - Street 1:5757 W CENTURY BLVD FL 6
Practice Address - Street 2:STE 650R
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-6401
Practice Address - Country:US
Practice Address - Phone:888-680-0863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-22
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95025226363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health