Provider Demographics
NPI:1427387877
Name:PARKER, CHARLENE (RN, NP-BC)
Entity Type:Individual
Prefix:
First Name:CHARLENE
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:RN, NP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4924 BALBOA BLVD # 257
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-3402
Mailing Address - Country:US
Mailing Address - Phone:818-400-5753
Mailing Address - Fax:
Practice Address - Street 1:22231 MULHOLLAND HWY STE 106
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-5178
Practice Address - Country:US
Practice Address - Phone:818-222-9300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-14
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA276131363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner