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General NPI Number Information
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NPI Number | 1780440065
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Entity Type | Individual
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Provider Name | KYLE TRETTER PMHNP
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Gender | Male
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Dates
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Enumeration Date | 02/26/2024
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Last Update Date | 11/26/2025
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Provider Practice Location Address
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Address Line | 955 N OXFORD AVE APT 3
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City | LOS ANGELES
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State | CA
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Zip | 90029-3266
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Country | US
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Telephone | 916-900-2926
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Fax | 430-209-0117
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Provider Business Mailing Address
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Address Line | 955 N OXFORD AVE APT 3
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City | LOS ANGELES
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State | CA
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Zip | 90029-3266
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Country | US
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Telephone | 812-774-0349
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Fax | 430-209-0117
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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 | 95028054
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License Number State | CA
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