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General NPI Number Information
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NPI Number | 1760861512
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Entity Type | Individual
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Provider Name | CHARLOTTE SUZANNE KALB AGNP-BC, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 05/27/2015
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Last Update Date | 01/28/2026
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Provider Practice Location Address
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Address Line | 4695 MACARTHUR CT
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-1882
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Country | US
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Telephone | 949-649-4093
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Fax | 949-818-5372
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Provider Business Mailing Address
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Address Line | 167 HARBOR CV
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City | BREVARD
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State | NC
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Zip | 28712-7839
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Country | US
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Telephone | 248-259-5565
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RXN.0110335-NP
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 95005158
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License Number State | CA
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