Provider Demographics
NPI:1801027248
Name:NIELSEN-MENICUCCI, KAREN (PHD, RN, CNS, PHN)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:
Last Name:NIELSEN-MENICUCCI
Suffix:
Gender:F
Credentials:PHD, RN, CNS, PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5151 STATE UNIVERSITY AVE
Mailing Address - Street 2:SCHOOL OF NURSING - CSULA
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90032
Mailing Address - Country:US
Mailing Address - Phone:323-343-4194
Mailing Address - Fax:
Practice Address - Street 1:5151 STATE UNIVERSITY AVE
Practice Address - Street 2:SCHOOL OF NURSING - CSULA
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90032
Practice Address - Country:US
Practice Address - Phone:323-343-4194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-03
Last Update Date:2009-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA282840163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health