Individual
ANNIE ELIZABETH WAYNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1115 S SUNSET AVE, WEST COVINA, CA 91790-3940
(626) 962-4011
Mailing address
1354 KOLLN ST, PLEASANTON, CA 94566-5631
(925) 200-8085
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
63098
CA
363A00000X
Physician Assistant
—
—
Other
Enumeration date
05/02/2023
Last updated
08/03/2023
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