Basic Information
| Provider Information | |||||||||
| NPI: | 1255608741 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ARMENDARIZ | ||||||||
| FirstName: | JAMIE | ||||||||
| MiddleName: | HIDALGO | ||||||||
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| Credential: | RN, MSN, FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12900 PARK PLAZA DR | ||||||||
| Address2: | STE 150 | ||||||||
| City: | CERRITOS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 907039329 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8666463553 | ||||||||
| FaxNumber: | 5626223058 | ||||||||
| Practice Location | |||||||||
| Address1: | 4074 VAN BUREN PL. | ||||||||
| Address2: | |||||||||
| City: | CULVER CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902322828 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5628050072 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/28/2011 | ||||||||
| LastUpdateDate: | 05/29/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 21108 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.