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General NPI Number Information
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NPI Number | 1346661105
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Entity Type | Individual
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Provider Name | CHONA PEDRAJA RN,MSN,CCRN,ACNP-BC
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Gender | Female
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Dates
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Enumeration Date | 12/21/2013
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Last Update Date | 05/19/2020
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Provider Practice Location Address
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Address Line | 1420 S CENTRAL AVE
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City | GLENDALE
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State | CA
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Zip | 91204-2508
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Country | US
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Telephone | 818-502-1900
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Fax |
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Provider Business Mailing Address
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Address Line | 4140 W 190TH ST
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City | TORRANCE
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State | CA
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Zip | 90504-5513
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Country | US
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Telephone | 310-423-2077
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 21167
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License Number State | CA
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