IndividualActive
Glenn Petillo
NPI 1770936635 · Nurse's Aide · Anza, CA
Provider details
- NPI number
- 1770936635
- Entity type
- Individual
- Primary specialty
- Nurse's AideNursing Service Related Providers
- Sex
- Male
- Sole proprietor
- No
- License
- 00903914 (CA)
Specialties & taxonomies
Nursing Service Related Providers
Nursing Service Related Providers
Profile Score
Established profile(71/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
37802 Fischer Rd
Anza, CA 92539-9203
Phone: (951) 551-3204
Street-level locationGet directions
Mailing address
37802 Fischer Rd
Anza, CA 92539-9203
Registry dates
- Enumerated
- 2016-07-15
- Last updated
- 2016-07-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.