Individual
KYLE ANTHONY DELA CUESTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BSN, RN
Contact information
Practice address
1812 VERDUGO BLVD, GLENDALE, CA 91208-1407
(818) 952-2270
Mailing address
2173 YOSEMITE AVE, SIMI VALLEY, CA 93063-3536
(805) 428-0872
Taxonomy
Speciality
Code
Description
License number
State
163WG0600X
Gerontology Registered Nurse
95166664
CA
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
95166664
CA
Other
Enumeration date
08/06/2021
Last updated
08/06/2021
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