Grace Wiryawan, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95019521 Issued in CA

Practice address

3030 W Ball Rd
Anaheim, CA 92804-3897

Phone

(626) 872-9844

NPI assigned

Mar 21, 2022

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1647820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647820800000",
    "number": "1003565664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N ATLANTIC BLVD APT 302",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918012230",
            "telephone_number": "626-872-9844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 W BALL RD",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928043897",
            "telephone_number": "626-872-9844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIRYAWAN",
        "first_name": "GRACE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-21",
        "last_updated": "2022-03-21",
        "certification_date": "2022-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95019521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elijah Winfield
• Emma Raye Wingate
• Wings of Kindness Alas de Bondad
• Kaya Jeanine Winkler
• Lorna M Winterrowd
• Dennis Clayton Witherwax, R.PH.
• Whitney Withnell
• Angelica Brianna Witter, MED
• Dulce I Wohlford
• Mindi Wolf, B.A. PSYCHOLOGY

• Family Nurse Practitioner in Anaheim, CA
• Providers in Anaheim, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.