Individual
HAWANATU SILLAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1300 W 7TH ST, SAN PEDRO, CA 90732-3505
(213) 984-0474
Mailing address
15311 GUNDRY AVE UNIT 8, PARAMOUNT, CA 90723-3987
(213) 984-0474
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN95238122
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95026016
CA
Other
Enumeration date
03/25/2021
Last updated
07/31/2023
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