Individual
MR. IAN MAXWELL MATTHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
13160 MINDANAO WAY STE 213, MARINA DEL REY, CA 90292-6358
(925) 282-1778
(415) 296-5299
Mailing address
13160 MINDANAO WAY STE 213, MARINA DEL REY, CA 90292-6358
(925) 282-1778
(415) 296-5299
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
889538
NY
163W00000X
Registered Nurse
95171771
CA
163W00000X
Registered Nurse
RN2383657
MA
163W00000X
Registered Nurse
RN9636729
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
405126
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
AC006045
MD
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
APRN11027493
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
NP95014083
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
RN2383657
MA
Other
Enumeration date
08/26/2019
Last updated
10/11/2024
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