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Michelle Cristal Cardenas

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

200 Ucla Medical Plz Ste 140, Los Angeles, CA 90095-2460

PECOS Enrollment

This provider is enrolled in PECOS as MICHELLE CARDENAS.

Based on the most recent information from CMS, provider Michelle Cristal Cardenas is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records today at 11:47 AM.

Profile Details

Provider ID
1548036817
Provider Type
Individual
Full Name
Cardenas, Michelle Cristal
Credential
NP

Gender
Female
Sole Proprietor
Yes
Enumeration Date
11/28/2023
Last Updated
8/30/2024

Contact Information

Practice Location

200 Ucla Medical Plz Ste 140, Los Angeles, CA 90095-2460

(310) 794-7700

Unlisted Fax

Mailing Location

5767 W Century Blvd Ste 400, Los Angeles, CA 90045-5631

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363L00000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License NP95025110 California
Code 363LF0000X	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 95025110 California

Michelle Cristal Cardenas

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

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