Provider Demographics
NPI:1184941098
Name:WARREN, GIANNA ANGELA CHRISHUANA (PA-C)
Entity type:Individual
Prefix:
First Name:GIANNA
Middle Name:ANGELA CHRISHUANA
Last Name:WARREN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4859 W SLAUSON AVE STE 368
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90056-3213
Mailing Address - Country:US
Mailing Address - Phone:323-823-1983
Mailing Address - Fax:
Practice Address - Street 1:905 S PRAIRIE AVE STE A
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-4140
Practice Address - Country:US
Practice Address - Phone:310-946-2533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-02
Last Update Date:2016-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA20940363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant