Individual
KAITLYNN MENJO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP, RN
Contact information
Practice address
808 W 58TH ST, LOS ANGELES, CA 90037-3632
(323) 541-1600
Mailing address
4803 HERSHOLT AVE, LONG BEACH, CA 90808-1130
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
95015021
CA
Other
Enumeration date
10/14/2020
Last updated
10/14/2020
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