Basic Information
| Provider Information | |||||||||
| NPI: | 1396410791 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | PENA | ||||||||
| FirstName: | FRANKI | ||||||||
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| Credential: | AGACNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1251 PALMS BLVD | ||||||||
| Address2: | |||||||||
| City: | VENICE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902912905 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3476269780 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4900 CALIFORNIA AVE | ||||||||
| Address2: | TOWER B, STE 210B | ||||||||
| City: | BAKERSFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 933097080 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8669490108 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/09/2021 | ||||||||
| LastUpdateDate: | 10/26/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/26/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2100X | 431934 | NY | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care | 363LA2100X | 95018075 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
No ID Information.