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General NPI Number Information
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NPI Number | 1144572025
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Entity Type | Individual
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Provider Name | CARLA MAE TENORIO CUISIA-ZIMMER MSN FNP
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Gender | Female
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Dates
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Enumeration Date | 10/03/2012
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Last Update Date | 02/11/2022
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Provider Practice Location Address
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Address Line | 18300 ROSCOE BLVD
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City | NORTHRIDGE
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State | CA
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Zip | 91325-4105
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Country | US
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Telephone | 818-885-5396
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Fax |
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Provider Business Mailing Address
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Address Line | 28418 FARRIER DR
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City | VALENCIA
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State | CA
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Zip | 91354-4501
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Country | US
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Telephone | 909-918-9517
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 22213
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License Number State | CA
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