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General NPI Number Information
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NPI Number | 1316743867
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Entity Type | Individual
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Provider Name | MICAELA PERICONE-KAPP DNP
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Gender | Female
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Dates
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Enumeration Date | 02/24/2025
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | 18321 CLARK ST
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City | TARZANA
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State | CA
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Zip | 91356-3501
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Country | US
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Telephone | 818-881-0800
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Fax |
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Provider Business Mailing Address
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Address Line | 22717 HATTERAS ST
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City | WOODLAND HILLS
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State | CA
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Zip | 91367-4449
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Country | US
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Telephone | 805-889-5968
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 95034714
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 95160720
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License Number State | CA
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