Individual provider · Type 1 NPI
Kimberly Casiano Mendenhall, PNP
Pediatric Nurse Practitioner · Los Angeles, CA
NPI number
1114646759
Active
Practice location
757 Westwood Plz
Los Angeles, CA 90095-8358
Mailing address
5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatrics Physician | 208000000X | 95022072 (CA) |
| Pediatric Nurse Practitioner Primary | 363LP0200X | 95022072 (CA) |
Pediatric Nurse Practitioner: Definition to come...
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About NPI 1114646759
Kimberly Casiano Mendenhall, PNP's National Provider Identifier is 1114646759, issued on Aug 25, 2022. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Los Angeles, CA. The record was last updated on Feb 21, 2023.