Provider Demographics
NPI:1396410791
Name:PENA, FRANKI (AGACNP-BC)
Entity type:Individual
Prefix:
First Name:FRANKI
Middle Name:
Last Name:PENA
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1251 PALMS BLVD
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:CA
Mailing Address - Zip Code:90291-2905
Mailing Address - Country:US
Mailing Address - Phone:347-626-9780
Mailing Address - Fax:
Practice Address - Street 1:4900 CALIFORNIA AVE
Practice Address - Street 2:TOWER B, STE 210B
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-7080
Practice Address - Country:US
Practice Address - Phone:866-949-0108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-09
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY431934363LA2100X
CA95018075363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care