Provider Demographics
NPI:1023556545
Name:GIGLIOTTI, ANNIE (LAC)
Entity type:Individual
Prefix:MISS
First Name:ANNIE
Middle Name:
Last Name:GIGLIOTTI
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1044 PACIFIC ST APT 2
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90405-1444
Mailing Address - Country:US
Mailing Address - Phone:310-927-1978
Mailing Address - Fax:
Practice Address - Street 1:1044 PACIFIC ST APT 2
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90405-1444
Practice Address - Country:US
Practice Address - Phone:310-927-1978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-03
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA606746163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse