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NPI Code Detail

MEDICARE: MS. DENISE NICOLE SANDOVAL FNP-BC

MEDICARE: MS. DENISE NICOLE SANDOVAL FNP-BC
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
1363LF0000XFamily Nurse Practitioner95004966CA

General Provider Information

NPI Number : 1568910487
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DENISE NICOLE SANDOVAL FNP-BC
Provider Business Mailing Address
First Line : 7843 LANKERSHIM BLVD
Second Line :
City : NORTH HOLLYWOOD
State : CA
Zip : 91605-2523
Country : US
Telephone Number : 818-826-5555
Fax Number :
Provider Business Practice Location Address
First Line : 7843 LANKERSHIM BLVD
Second Line :
City : NORTH HOLLYWOOD
State : CA
Zip : 91605-2523
Country : US
Telephone Number : 818-826-5555
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2016
Last Update Date : 01/25/2021

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Directions to “ MS. DENISE NICOLE SANDOVAL FNP-BC” Practice Location

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