MEDICARE: MESHYLLE MARTIN-FERIDO DNP, PMHNP-BC, FNP

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	363LF0000X	Family Nurse Practitioner	95007899	CA
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	95007899	CA

General Provider Information

NPI Number	:	1518466432
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MESHYLLE MARTIN-FERIDO DNP, PMHNP-BC, FNP

Provider Business Mailing Address
First Line	:	9420 NOBLE AVE UNIT 112
Second Line	:
City	:	NORTH HILLS
State	:	CA
Zip	:	91343-7824
Country	:	US
Telephone Number	:	818-325-7147
Fax Number	:

Provider Business Practice Location Address
First Line	:	9420 NOBLE AVE UNIT 112
Second Line	:
City	:	NORTH HILLS
State	:	CA
Zip	:	91343-7824
Country	:	US
Telephone Number	:	818-325-7147
Fax Number	:

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

Provider Enumeration Date	:	02/06/2018
Last Update Date	:	01/21/2025

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