DR. KIRSTEN GAYLE MANALO EBUENGA PMHNP-BC DNP NPI 1497381651

NPI Information

NPI: 1497381651
Provider Name: DR. KIRSTEN GAYLE MANALO EBUENGA, PMHNP-BC, DNP
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
1401 N EL CAMINO REAL STE 100
SAN CLEMENTE, CA
ZIP 92672
Phone: (858) 522-0145
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DR. Kirsten Gayle Manalo Ebuenga, PMHNP-BC, DNP is a psychiatric/mental health nurse practitioner in San Clemente, CA with 3 years of experience. DR. Kirsten Gayle Manalo Ebuenga, PMHNP-BC, DNP NPI is 1497381651. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1401 N EL CAMINO REAL STE 100
SAN CLEMENTE, CA
ZIP 92672-983
Phone: (858) 522-0145

The NPI 1497381651 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/19/2020 and was last updated on 12/29/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	390200000X	Student in an Organized Health Care Education/Training Program				No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	95019321	CALIFORNIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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