Healthcare Provider Details

I. General information

NPI: 1740753565
Provider Name (Legal Business Name): PEDRO FIGUEROA NP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2019
Last Update Date: 12/28/2021
Certification Date: 12/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14659 OLIVE VIEW DR
SYLMAR CA
91342-1652
US

IV. Provider business mailing address

6860 BELLAIRE AVE
NORTH HOLLYWOOD CA
91605-5220
US

V. Phone/Fax

Practice location:
  • Phone: 818-485-0867
  • Fax: 818-833-5690
Mailing address:
  • Phone: 818-219-3759
  • Fax: 818-219-3759

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number95154943
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95019578
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: