Healthcare Provider Details

I. General information

NPI: 1871817965
Provider Name (Legal Business Name): MARCIA VIANA FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARCIA KINDRED

II. Dates (important events)

Enumeration Date: 03/18/2010
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4129 GAGE AVE
BELL CA
90201-1128
US

IV. Provider business mailing address

4129 GAGE AVE
BELL CA
90201-1128
US

V. Phone/Fax

Practice location:
  • Phone: 323-771-8400
  • Fax:
Mailing address:
  • Phone: 323-771-8400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95035737
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: