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General NPI Number Information
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NPI Number | 1366267809
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Entity Type | Individual
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Provider Name | CAROLYN PAMPALONE NP
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Gender | Female
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Dates
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Enumeration Date | 11/19/2024
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 21800 DEVONSHIRE ST STE B
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City | CHATSWORTH
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State | CA
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Zip | 91311-2905
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Country | US
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Telephone | 818-341-8888
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Fax |
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Provider Business Mailing Address
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Address Line | 13259 PEACH HILL RD
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City | MOORPARK
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State | CA
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Zip | 93021-2327
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Country | US
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Telephone | 818-437-4317
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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 | 95032794
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License Number State | CA
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