MR. RONALD MAR TENORIO ATILLO (NPI# 1346747391) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346747391 |
| Entity Type | Individual |
| Full Name | MR. RONALD MAR TENORIO ATILLO |
| Credential | AG-ACNP-BC |
| Practice Address |
16133 Ventura Blvd Ste 360 Encino CA 91436 |
| Mailing Address |
511 N Jackson St Apt 202 Glendale CA 91206-3267 |
| Practice Telephone | 1818986600 |
| Mailing Telephone | 2132688700 |
| Enumeration Date | 2018-04-06 |
| Last Update Date | 2018-07-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RN0300X |
Internal Medicine Specialization: Nephrology |
95008863 | CA | Allopathic & Osteopathic Physicians |
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
95008863 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
95008863 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | FURNISHING NUMBER | 95008863 | 01 |
| CA | BOARD OF NURSING | 768953 | 01 |
| CA | AMERICAN ASSOCIATION OF CRITICAL CARE NURSES | 2000070078 | 01 |
| CA | CALIFORNIA BOARD OF NURSING | 95008863 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 28062 Baxter Rd, Murrieta, CA 925631401 | 9512904000 | |
| 511 N Jackson St Apt 202, Glendale, CA 912063267 | 2132688700 |
| Street Address |
16133 VENTURA BLVD STE 360 |
| City | ENCINO |
| State | CA |
| Zip Code | 91436 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689660359 | David H Stern | Internal Medicine | 16133 Ventura Blvd Ste 360, Encino, CA 91436-2426 | 2005-09-27 |
| 1063995918 | Maya King | Nurse Practitioner | 16133 Ventura Blvd Ste 360, Encino, CA 91436-2426 | 2018-09-06 |
| 1205370236 | Marcie Jo Hoppe | Nurse Practitioner | 16133 Ventura Blvd Ste 360, Encino, CA 91436-2426 | 2016-12-09 |
| 1619179454 | Nima Rabbani | Internal Medicine | 16133 Ventura Blvd Ste 360, Encino, CA 91436-2426 | 2007-06-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801405014 | Find Your Balance, Center for Growth & Change Inc. | Marriage & Family Therapist | 15720 Ventura Blvd Suite 603, Encino, CA 91436 | 2020-07-24 |
| 1396214482 | Maria Guadalupe Cruz | Behavior Technician | 16500 Ventura Blvd # 414, Encino, CA 91436 | 2018-11-19 |
| 1699277186 | Rodolfo Alavez Jimenez | Behavior Technician | 16500 Ventura Blvd., Suite 414, Encino, CA 91436 | 2018-03-01 |
| 1750891503 | Robert James Kim-farley | Preventive Medicine | 4037 Rogen Drive, Encino, CA 91436 | 2017-10-06 |
| 1528577871 | Julia Szpakiewicz | Marriage & Family Therapist | 16550 Ventura Blvd 318, Encino, CA 91436 | 2017-09-28 |
| 1457875452 | Jeffrey Proniloff | Dentist | 16680 Ashley Oaks, Encino, CA 91436 | 2017-08-01 |
| 1114449592 | Loren Lizeth Huerta | Specialist/Technologist | 16500 Ventura Blvd #414, Encino, CA 91436 | 2017-07-07 |
| 1538619838 | Gilbert Torres Jr. | Physical Therapist | 16260 Ventura Blvd # 600, Encino Medical Tower, Encino, CA 91436 | 2016-10-11 |
| 1417313529 | Nancy L Reynolds | Marriage & Family Therapist | 16055 Ventura Blvd #409, Encino, CA 91436 | 2016-01-05 |
| 1457716748 | Salvador Salgado | Behavioral Analyst | 16500 Ventura Blvd. Suite 414, Encino, CA 91436 | 2015-12-31 |
| Find all providers in zip 91436 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821441114 | Noel Nunez | Nurse Practitioner | 16350 Ventura Blvd Unit 309, Encino, CA 91436-5307 | 2016-07-21 |
| 1063995918 | Maya King | Nurse Practitioner | 16133 Ventura Blvd Ste 360, Encino, CA 91436-2426 | 2018-09-06 |
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| 1023619442 | Dolores Josephine Meehan | Nurse Practitioner | South Bay Vascular Center, 2255 South Bascom Avenue Suite 200, Campbell, CA 95008-7800 | 2020-11-03 |
| 1013517960 | Kristina Pulliam Markey | Nurse Practitioner | 11234 Anderson Strreet, Loma Linda, CA 92354 | 2020-10-29 |
| 1851990550 | Fernanda Monteon Ibarra | Nurse Practitioner | 30222 Belmont Ct, Agoura Hills, CA 91301-4611 | 2020-10-22 |
| 1780283168 | Brenda Rienru Rhima | Nurse Practitioner | 24657 Rockston Dr, Corona, CA 92883-1614 | 2020-10-18 |
| 1215535034 | Shiji John | Nurse Practitioner | 3765 Gunnison Cir, Corona, CA 92881-8486 | 2020-10-14 |
| 1053919258 | Lacey Etienne Neufeld | Nurse Practitioner | Marshall Transitional Care Unit, 1100 Marshall Way, Placerville, CA 95667 | 2020-10-12 |
| 1063028298 | Kanokwan Kultan | Nurse Practitioner | 15850 Babcock St, San Diego, CA 92127-3680 | 2020-09-22 |
| 1538775093 | David Lee | Nurse Practitioner | 5710 S Glennie Ln Apt A, Los Angeles, CA 90016-1063 | 2020-09-21 |
| 1124634886 | Catherine Kestenian | Nurse Practitioner | 351 E Foothill Blvd Ste 250, Arcadia, CA 91006-7426 | 2020-09-18 |
| 1285249565 | Anu Tharoor | Nurse Practitioner | 505 Parnassus Ave Fl 9, San Francisco, CA 94143-2204 | 2020-09-13 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.