Healthcare Provider Details

I. General information

NPI: 1750116075
Provider Name (Legal Business Name): PAMELA KEINDL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2024
Last Update Date: 09/05/2024
Certification Date: 09/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3043 MACARTHUR DR
MARINA CA
93933-4763
US

IV. Provider business mailing address

PO BOX 3222
MONTEREY CA
93942-3222
US

V. Phone/Fax

Practice location:
  • Phone: 831-649-4522
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number95385101
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: