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General NPI Number Information
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NPI Number | 1689545733
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Entity Type | Individual
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Provider Name | KAITLIN CERAGIOLI
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Gender | Female
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Dates
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Enumeration Date | 09/12/2025
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Last Update Date | 09/12/2025
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Provider Practice Location Address
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Address Line | 2200 W MAGNOLIA BLVD
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City | BURBANK
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State | CA
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Zip | 91506-1734
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Country | US
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Telephone | 818-841-9990
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Fax |
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Provider Business Mailing Address
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Address Line | 1187 S ORANGE GROVE BLVD
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City | PASADENA
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State | CA
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Zip | 91105-3344
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Country | US
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Telephone | 626-221-8928
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 95036647
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License Number State | CA
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