Provider Demographics
NPI:1558411462
Name:CRONIN, KATHRYN HELEN (NP)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:HELEN
Last Name:CRONIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:HELEN
Other - Last Name:PITILLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:14445 OLIVE VIEW DR
Mailing Address - Street 2:
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91342-1437
Mailing Address - Country:US
Mailing Address - Phone:818-364-3205
Mailing Address - Fax:818-364-4573
Practice Address - Street 1:14445 OLIVE VIEW DR
Practice Address - Street 2:
Practice Address - City:SYLMAR
Practice Address - State:CA
Practice Address - Zip Code:91342-1437
Practice Address - Country:US
Practice Address - Phone:818-364-3205
Practice Address - Fax:818-364-4573
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2014-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA535681363L00000X
CANP15218363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner