Bantol, Ken Iven

Bantol, Ken Iven is an sole proprietor health care provider with primary practice located at 10400 Gloria Ave , Granada Hills CA 91344-7123. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as his primary health care specialty. Bantol, Ken Iven can be contacted via phone (818) 867-0500.

Contact Information

Primary practice address
10400 Gloria Ave Granada Hills CA 91344-7123
Phone: (818) 867-0500
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 95027351 California

Profile Details

NPI number 1841055811
LBN Legal business name Bantol, Ken Iven
Credentials PMHNP-BC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 19th, 2024
Last updated Feb 19th, 2024 - about 10 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841055811 NPPES
California Other 95027351 NURSE PRACTITIONER FURNISHING

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