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General NPI Number Information
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NPI Number | 1588936983
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Entity Type | Individual
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Provider Name | SHERRI MARIE MUNDALL CPNP
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Gender | Female
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Dates
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Enumeration Date | 01/31/2012
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Last Update Date | 03/15/2021
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Provider Practice Location Address
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Address Line | 15477 VENTURA BLVD FL 3
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-3006
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Country | US
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Telephone | 818-292-4509
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Fax | 818-907-0360
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Provider Business Mailing Address
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Address Line | 15477 VENTURA BLVD FL 3
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-3006
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Country | US
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Telephone | 818-292-4509
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Fax | 818-907-0360
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 15356
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License Number State | CA
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