Healthcare Provider Details

I. General information

NPI: 1013864941
Provider Name (Legal Business Name): JONELL ANDREA PERROTTA PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2026
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6464 W SUNSET BLVD STE AND750
LOS ANGELES CA
90028-8001
US

IV. Provider business mailing address

17612 BESSEMER ST
ENCINO CA
91316-1211
US

V. Phone/Fax

Practice location:
  • Phone: 814-931-9337
  • Fax:
Mailing address:
  • Phone: 814-931-9337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95038752
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: