Healthcare Provider Details

I. General information

NPI: 1891461521
Provider Name (Legal Business Name): KRISTIN DARLENE SAAD FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2021
Last Update Date: 09/13/2021
Certification Date: 08/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1145 W REDONDO BEACH BLVD
GARDENA CA
90247-3511
US

IV. Provider business mailing address

23304 SESAME ST # 16A
TORRANCE CA
90502-3067
US

V. Phone/Fax

Practice location:
  • Phone: 310-532-4200
  • Fax:
Mailing address:
  • Phone: 508-333-5492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95018184
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: