MEDICARE: KRISTINE MBAMALU NURSE PRACTITIONER AND NURSING SERVICES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse
2	363L00000X	Nurse Practitioner

General Provider Information

NPI Number	:	1023899481
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KRISTINE MBAMALU NURSE PRACTITIONER AND NURSING SERVICES INC

Provider Business Mailing Address
First Line	:	21550 OXNARD ST FL 3
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91367-7105
Country	:	US
Telephone Number	:	310-531-6645
Fax Number	:	310-531-6645

Provider Business Practice Location Address
First Line	:	21550 OXNARD ST FL 3
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91367-7105
Country	:	US
Telephone Number	:	310-531-6645
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KRISTINE MBAMALU
Credential	:
Telephone Number	:	310-531-6645

Provider Enumeration Date	:	10/11/2023
Last Update Date	:	12/29/2025

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