Provider Demographics
NPI:1477385409
Name:UNVER, DIDEM KADRIYE (ACNPC-AG)
Entity type:Individual
Prefix:
First Name:DIDEM
Middle Name:KADRIYE
Last Name:UNVER
Suffix:
Gender:F
Credentials:ACNPC-AG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 EDGEWOOD
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3994
Mailing Address - Country:US
Mailing Address - Phone:512-228-8267
Mailing Address - Fax:
Practice Address - Street 1:67 EDGEWOOD
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3994
Practice Address - Country:US
Practice Address - Phone:512-228-8267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-19
Last Update Date:2024-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95032214363LA2100X
CA95184545163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine