Healthcare Provider Details

I. General information

NPI: 1205978194
Provider Name (Legal Business Name): DONNA CAGLE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11600 INDIAN HILLS ROAD
MISSION HILLS CA
91345
US

IV. Provider business mailing address

11600 INDIAN HILLS RD
MISSION HILLS CA
91345-1225
US

V. Phone/Fax

Practice location:
  • Phone: 818-489-7987
  • Fax:
Mailing address:
  • Phone: 818-838-7517
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number333477
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: