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General NPI Number Information
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NPI Number | 1013578491
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Entity Type | Individual
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Provider Name | BOBBIE SNOW MASENDA APRN FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 06/26/2019
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Last Update Date | 10/12/2023
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Provider Practice Location Address
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Address Line | 5901 W CENTURY BLVD STE 750
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City | LOS ANGELES
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State | CA
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Zip | 90045-5443
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Country | US
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Telephone | 877-356-2503
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 398664
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City | DALLAS
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State | TX
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Zip | 75339-8664
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Country | US
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Telephone | 469-732-9781
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP142008
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | NP95025764
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License Number State | CA
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