Amie Alonzo Cohen, AGPCNP-BC

Individual provider Active NPI Nurse Practitioner · San Marino, CA

NPI 1548076995 · NPPES record last updated Dec 9, 2024

Key facts

NPI
1548076995
Entity type
Individual (NPI type 1)
Primary specialty
Nurse Practitioner 363L00000X
License
95032921 (CA)
Practice address
2705 Melville Dr
San Marino, CA 91108-2903
Phone
(626) 840-4601
NPI assigned
Dec 9, 2024
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
95032921CAMDNurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95032921 CA Yes

Addresses

Primary practice location

2705 Melville Dr
San Marino, CA 91108-2903

Mailing address

2705 Melville Dr
San Marino, CA 91108-2903
Phone (626) 840-4601

Other providers in San Marino, CA

All providers in San Marino, CA · Nurse Practitioner in California

Sources for this page

Verify at the official NPI Registry.