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NPI Code Detail

MEDICARE: MR. JOHN FUJIWARA FNP-C PMHNP-BC

MEDICARE: MR. JOHN FUJIWARA FNP-C PMHNP-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
1163WP0808XPsychiatric/Mental Health Registered Nurse95122533CA
2363LF0000XFamily Nurse Practitioner95013404CA

General Provider Information

NPI Number : 1992205926
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOHN FUJIWARA FNP-C PMHNP-BC
Provider Business Mailing Address
First Line : 200 S SAN PEDRO ST STE 302
Second Line :
City : LOS ANGELES
State : CA
Zip : 90012-5308
Country : US
Telephone Number : 213-680-0355
Fax Number : 323-980-4848
Provider Business Practice Location Address
First Line : 200 S SAN PEDRO ST STE 302
Second Line :
City : LOS ANGELES
State : CA
Zip : 90012-5308
Country : US
Telephone Number : 213-680-0355
Fax Number : 323-980-4848
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2018
Last Update Date : 09/10/2022

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