Healthcare Provider Details

I. General information

NPI: 1871450429
Provider Name (Legal Business Name): CHYNNA ROZETTE COLMENARES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 USA DRIVE
MOBILE AL
36688-0001
US

IV. Provider business mailing address

PO BOX 3713
CHATSWORTH CA
91313-3713
US

V. Phone/Fax

Practice location:
  • Phone: 251-445-9400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95039596
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95167523
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: