MEDICARE: CATHERINE KESTENIAN

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	363LA2100X	Acute Care Nurse Practitioner	95014952	CA
2	363LG0600X	Gerontology Nurse Practitioner	95014952	CA

General Provider Information

NPI Number	:	1124634886
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHERINE KESTENIAN

Provider Business Mailing Address
First Line	:	1241 E ELMWOOD AVE
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91501-1615
Country	:	US
Telephone Number	:	818-397-2255
Fax Number	:

Provider Business Practice Location Address
First Line	:	351 E FOOTHILL BLVD STE 250
Second Line	:
City	:	ARCADIA
State	:	CA
Zip	:	91006-7426
Country	:	US
Telephone Number	:	818-397-2255
Fax Number	:	818-553-6656

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/18/2020
Last Update Date	:	09/18/2020

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Directions to “ CATHERINE KESTENIAN ” Practice Location

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