Provider Demographics
NPI:1225912900
Name:IMANI, MONA (FNP)
Entity type:Individual
Prefix:
First Name:MONA
Middle Name:
Last Name:IMANI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:MONA
Other - Middle Name:
Other - Last Name:IMANI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:8508 MOORCROFT AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91304-2205
Mailing Address - Country:US
Mailing Address - Phone:310-926-4070
Mailing Address - Fax:
Practice Address - Street 1:8508 MOORCROFT AVE
Practice Address - Street 2:
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91304-2205
Practice Address - Country:US
Practice Address - Phone:310-926-4070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95036337363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily