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NPI Code Detail

MEDICARE: DR. KATHRYN LIBUSER SATYUKOV PMHNP, DNP

MEDICARE: DR. KATHRYN LIBUSER SATYUKOV PMHNP, DNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse833635CA
2363LP0808XPsychiatric/Mental Health Nurse Practitioner95029499CA

General Provider Information

NPI Number : 1174135321
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KATHRYN LIBUSER SATYUKOV PMHNP, DNP
Provider Business Mailing Address
First Line : 400 CORPORATE POINTE STE 300
Second Line :
City : CULVER CITY
State : CA
Zip : 90230-7620
Country : US
Telephone Number : 602-767-2456
Fax Number :
Provider Business Practice Location Address
First Line : 400 CORPORATE POINTE STE 300
Second Line :
City : CULVER CITY
State : CA
Zip : 90230-7620
Country : US
Telephone Number : 602-767-2456
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2020
Last Update Date : 12/15/2024

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