GRACE WOODROW PARK NP
NPI 1306127964
Nurse Practitioner in Santa Ana, CA

Q: What is Grace Park's NPI number?

The NPI number for Grace Park is 1306127964. It was assigned to this individual provider in the NPPES registry on September 8, 2011.

Q: What is Grace Park's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Grace Park was last updated on July 28, 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.

Active since September 08, 2011

1801 PARK COURT PL BLDG H, SANTA ANA, CA 92701(714) 881-8601 Get Directions Write a Review

NPPES record last updated: July 28, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 28, 2022, Dec 15, 2021 (2 updates tracked since 2021).

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About Grace Woodrow Park Np NPPES

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

GRACE WOODROW PARK NP (NPI 1306127964) is an individual nurse practitioner in Santa Ana, California, licensed in California (95013933) and active in the NPI registry since September 2011. She maintains a secondary practice location in Berkeley.

NPPES Registry Identity

NPI1306127964

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameGRACE WOODROW PARKCredential: NP

Location Address1801 PARK COURT PL BLDG HSanta Ana, CA 92701-5028

Mailing Address1400 Shattuck Ave Ste 12Berkeley, CA 94709-1411 · (510) 224-5354 · Fax (415) 449-8617

Phone(714) 881-8601

Sole ProprietorNo

Enumeration DateSeptember 8, 2011

Last NPPES UpdateJuly 28, 20222 updates tracked since enumeration

NPPES CertifiedJuly 17, 2022

✔ NPI 1306127964 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in CA · 95013933

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Also ListedRegistered NurseTaxonomy 163W00000X · License 804756 (CA)

1801 PARK COURT PL BLDG H, Santa Ana, CA 92701

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Secondary Practice Location 1

Location 11400 Shattuck Ave Ste 12Berkeley, CA 94709-1411 · Phone (510) 224-5354 · Fax (415) 449-8617

Other Providers at the Same Location NPPES 20

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

AMBER KHAN

Social Worker (Clinical)