Grace Woodrow Park, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95013933 Issued in CA

Practice address

1801 Park Court PL BLDG H
Santa Ana, CA 92701-5028

Phone

(714) 881-8601

NPI assigned

Sep 8, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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": "1315440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658966400000",
    "number": "1306127964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 SHATTUCK AVE STE 12",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947091411",
            "telephone_number": "510-224-5354",
            "fax_number": "415-449-8617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 PARK COURT PL BLDG H",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927015028",
            "telephone_number": "714-881-8601"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 Shattuck Ave Ste 12",
            "address_purpose": "LOCATION",
            "city": "Berkeley",
            "state": "CA",
            "postal_code": "947091411",
            "country_code": "US",
            "telephone_number": "510-224-5354",
            "fax_number": "415-449-8617",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "GRACE",
        "middle_name": "WOODROW",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-08",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "804756",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95013933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Park
• Bojun Park, D.D.S.
• Charles C Park, D.D.S.
• Frances Park
• Gil Ja Park
• Hannah Park
• Helen Park, O.D.
• Irene Park
• Jaewoong Park, L.AC
• Jai Sin Park

• Nurse Practitioner in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 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.