GRACE WIRYAWAN NP
NPI 1003565664
Nurse Practitioner - Family in Anaheim, CA

Active since March 21, 2022
3030 W BALL RD, ANAHEIM, CA 92804(626) 872-9844 Get Directions Write a Review

NPPES record last updated: March 21, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Grace Wiryawan Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GRACE WIRYAWAN NP (NPI 1003565664) is an individual family provider in Anaheim, California, licensed in California (95019521) and active in the NPI registry since March 2022.

NPPES Registry Identity

NPI1003565664
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameGRACE WIRYAWANCredential: NP
Location Address3030 W BALL RDAnaheim, CA 92804-3897
Mailing Address500 N Atlantic Blvd Apt 302Alhambra, CA 91801-2230 · (626) 872-9844
Sole ProprietorYes
Enumeration DateMarch 21, 2022
NPPES CertifiedMarch 21, 2022
NPI 1003565664 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License Licensed in CA · 95019521
3030 W BALL RD, Anaheim, CA 92804

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Clinic/Center (Primary Care)
3030 W BALL RD
ANAHEIM, CA 92804
Family Medicine (Adult Medicine)
3030 W BALL RD
ANAHEIM, CA 92804

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Grace Wiryawan's NPI number?

The NPI number for Grace Wiryawan is 1003565664. It was assigned to this individual provider in the NPPES registry on March 21, 2022.

Where is Grace Wiryawan located?

Grace Wiryawan practices at 3030 W Ball Rd, Anaheim, CA 92804. The listed phone number is (626) 872-9844.

What is Grace Wiryawan's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Grace Wiryawan was last updated on March 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.