Provider Demographics
NPI:1205953254
Name:PEDONE, BETTINA NICOLE (RN, MSN, RNP)
Entity type:Individual
Prefix:
First Name:BETTINA
Middle Name:NICOLE
Last Name:PEDONE
Suffix:
Gender:F
Credentials:RN, MSN, RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 WESTWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-1703
Mailing Address - Country:US
Mailing Address - Phone:310-794-1910
Mailing Address - Fax:310-267-1996
Practice Address - Street 1:221 WESTWOOD BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-1703
Practice Address - Country:US
Practice Address - Phone:310-794-1910
Practice Address - Fax:310-267-1996
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA542330363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily