Provider Demographics
NPI:1902979552
Name:KEREN-ZVI, ANN C
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:C
Last Name:KEREN-ZVI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6115 LINDENHURST AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-4808
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7150 TAMPA AVE
Practice Address - Street 2:
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-3700
Practice Address - Country:US
Practice Address - Phone:818-774-3354
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10397363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA10397OtherNURSE PRACTITIONER CERT.
CAWNP10397AOtherPPIN (EV)
CAWNP10397BOtherPPIN (GV)
CA227060OtherREGISTERED NURSE LICENSE
CA227060OtherREGISTERED NURSE LICENSE
CAMK0600850OtherDEA #