JUDY B WITTENBERG BRAVARD


Address: 11101 Venice Blvd, Los Angeles, CA 90034-6914
Phone: 3108405755

JUDY B WITTENBERG BRAVARD (NPI# 1962664136) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1962664136
Entity Type Individual
Full Name JUDY B WITTENBERG BRAVARD
Credential CNP
Practice Address 11101 Venice Blvd
Los Angeles
CA 90034-6914
Mailing Address 843 Micheltorena St
Los Angeles
CA 90026-2701
Practice Telephone 3108405755
Practice Fax Number 3102185484
Mailing Telephone 3236647971
Enumeration Date 2008-06-30
Last Update Date 2012-07-02
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LW0102X Nurse Practitioner
Specialization: Women's Health
S292576 CA Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 11101 VENICE BLVD
City LOS ANGELES
State CA
Zip Code 90034-6914

Providers in the same location

NPI Name Taxonomy Address Enumeration
1023429230 Womens Clinic Clinic/Center 11101 Venice Blvd, Los Angeles, CA 90034-6914 2014-05-12

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Taxonomy Information

Taxonomy Code 363LW0102X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Women's Health

Taxonomy Definition

Definition to come...

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1710261177 Julia Reger Nurse Practitioner 554 N Plymouth Blvd, Los Angeles, CA 90004-1411 2011-10-04
1992083877 Talya Waldman Nurse Practitioner 8631 W Third Street, Suite 740 East, Los Angeles, CA 90048 2011-07-27
1548568728 Marion M Mayer Nurse Practitioner 9911 West Pico Blvd Suite 500, Los Angeles, CA 90035 2011-03-11
1205024171 Virginia Villegas Nurse Practitioner 4156 S Central Ave, Los Angeles, CA 90011-3154 2007-10-04
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1346306917 Cherokee Lynette Lavalley Nurse Practitioner 10024 S Vermont Ave, Los Angeles, CA 90044-3112 2006-12-28
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Competitor

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City LOS ANGELES
Zip Code 90034

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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