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Ken Iven Bantol, PMHNP-BC
Psychiatric/Mental Health Nurse Practitioner in Granada Hills, California
NPI 1841055811

Ken Iven Bantol is a Psychiatric/Mental Health Nurse Practitioner based in Granada Hills, CA and is specialized in Psychiatric/Mental Health. Ken Iven Bantol practices in Granada Hills, CA and has the professional credentials of PMHNP-BC. The NPI Number for Ken Iven Bantol is 1841055811 and holds a License No. 95027351 (California).

The current practice location address for Ken Iven Bantol is 10400 Gloria Ave, Granada Hills, CA and can be reached out via phone at 818-867-0500.

Location: 10400 Gloria Ave, Granada Hills, CA, 91344-7123
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Provider Profile Details
NPI Number
1841055811
Provider Name
Ken Iven Bantol
Credential
PMHNP-BC
Provider Entity Type
Individual
Gender
Male
Address
10400 Gloria Ave, Granada Hills, CA, 91344-7123
Phone Number
818-867-0500
Fax Number
Provider Enumeration Date
02/19/2024
Last Update Date
03/13/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
95027351 01 CA NURSE PRACTITIONER FURNISHING
institution
Provider Business Practice Location Address Details
Address
10400 Gloria Ave
City
State
Zip
91344-7123
Phone Number
818-867-0500
Fax Number
person
Provider Business Mailing Address Details
Address
10400 Gloria Ave
City
State
Zip
91344-7123
Phone Number
818-867-0500
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Psychiatric/Mental Health
Taxonomy
License No.
95027351 (California)
Definition
Definition to come...
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