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General NPI Number Information
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NPI Number | 1346729878
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Entity Type | Organization
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Legal Business Name | ANNA MEZENTSEVA, NURSING, INC
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Dates
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Enumeration Date | 08/07/2018
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Last Update Date | 08/07/2018
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Provider Practice Location Address
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Address Line | 4949 TYRONE AVE APT 7B
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City | SHERMAN OAKS
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State | CA
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Zip | 91423-1128
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Country | US
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Telephone | 661-309-2094
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Fax |
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Provider Business Mailing Address
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Address Line | 4949 TYRONE AVE APT 7B
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City | SHERMAN OAKS
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State | CA
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Zip | 91423-1128
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Country | US
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Telephone | 661-309-2094
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANNA MEZENTSEVA
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Credential | NP
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Telephone | 661-309-2094
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 95004339
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License Number State | CA
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