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Individual

JUDITH A ANDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPNP

Contact information

Practice address
15210 PARTHENIA ST, INORTH HILLS, CA 91343
(818) 895-3100
(818) 963-9464
Mailing address
11550 POEMA PL, CHATSWORTH, CA 91311-1119
(317) 937-5362

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
22789
CA
363LP0200X
Pediatric Nurse Practitioner
71002231A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200845120
IN
Enumeration date
10/13/2005
Last updated
02/22/2013
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