Individual provider Active NPI

Anne Nnenna Winfrey, NURSE PRACTITIONER

  • Psychiatric/Mental Health Nurse Practitioner
  • Harbor City, CA
National Provider Identifier
1306544549
Registry record updated Feb 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95024005 Issued in CA
Practice address
1177 Woodbury Dr
Harbor City, CA 90710-1242
Phone
(310) 729-4701
NPI assigned
Feb 17, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95024005 CA Primary

Addresses

Primary practice location

1177 Woodbury Dr
Harbor City, CA 90710-1242

Mailing address

1177 Woodbury Dr
Harbor City, CA 90710-1242
Phone (310) 729-4701

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230816003290 CA Practitioner - Nurse Practitioner 6608238068 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95024005CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Elom Nursing Practitioners Inc Psychiatric/Mental Health CurrentSince Dec 16, 2025 Accepting new patients
Grow Healthcare Group PC Psychiatric/Mental Health CurrentSince Jun 14, 2025 Accepting new patients
Ocean Pearl Healing, Inc. CurrentSince Jan 21, 2026 Accepting new patients
Elom Psychiatric Nurse Practitioners Psychiatric/Mental Health CurrentSince Mar 17, 2024 Accepting new patients

Locations

6281 Beach Blvd
Ste 213
Buena Park, CA 90621
Phone (562) 253-2783

400 Corporate Pointe
Ste 300
Los Angeles, CA 90230
Phone (213) 380-1399

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1676592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676592000000",
    "number": "1306544549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1177 WOODBURY DR",
            "city": "HARBOR CITY",
            "state": "CA",
            "postal_code": "907101242",
            "telephone_number": "310-729-4701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1177 WOODBURY DR",
            "city": "HARBOR CITY",
            "state": "CA",
            "postal_code": "907101242",
            "telephone_number": "310-729-4701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINFREY",
        "first_name": "ANNE",
        "middle_name": "NNENNA",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-17",
        "last_updated": "2023-02-17",
        "certification_date": "2023-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95024005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harbor City, CA

Sources for this page

Verify at the official NPI Registry.