Healthcare Provider Details

I. General information

NPI: 1194599183
Provider Name (Legal Business Name): CARMEN NAVEA URBAYAN DNP, RN, CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2023
Last Update Date: 11/09/2023
Certification Date: 11/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4867 W SUNSET BLVD FL 5
LOS ANGELES CA
90027-5969
US

IV. Provider business mailing address

9110 HUNTINGTON DR APT D
SAN GABRIEL CA
91775-1369
US

V. Phone/Fax

Practice location:
  • Phone: 323-783-4617
  • Fax:
Mailing address:
  • Phone: 661-330-3397
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number755719
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code364SP0200X
TaxonomyPediatric Clinical Nurse Specialist
License Number4279
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: