Ken Iven Bantol, PMHNP-BC - Nurse Practitioner in Granada Hills, CA

Ken Iven Bantol, PMHNP-BC is a Nurse Practitioner - Psychiatric/mental Health based in Granada Hills, California. Ken Iven Bantol is licensed to practice in California (license number 95027351) and his current practice location is 10400 Gloria Ave, Granada Hills, California. He can be reached at his office (for appointments etc.) via phone at (818) 867-0500.

NPI number for Ken Iven Bantol is 1841055811 and his current mailing address is 10400 Gloria Ave, Granada Hills, California. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1841055811.

Contact Information

Ken Iven Bantol, PMHNP-BC
10400 Gloria Ave,
Granada Hills, CA 91344-7123
(818) 867-0500
Not Available

Map and Direction




Provider's Profile

Full NameKen Iven Bantol
GenderMale
SpecialityNurse Practitioner - Psychiatric/mental Health
Location10400 Gloria Ave, Granada Hills, California
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1841055811
  • Provider Enumeration Date: 02/19/2024
  • Last Update Date: 02/19/2024

Medical Identifiers

Medical identifiers for Ken Iven Bantol such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1841055811NPI-NPPES
95027351OtherCANURSE PRACTITIONER FURNISHING

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LP0808XNurse Practitioner - Psychiatric/mental Health 95027351 (California)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ken Iven Bantol is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Ken Iven Bantol, PMHNP-BC
10400 Gloria Ave,
Granada Hills, CA 91344-7123

Ph: () -
Ken Iven Bantol, PMHNP-BC
10400 Gloria Ave,
Granada Hills, CA 91344-7123

Ph: (818) 867-0500

Reviews and Comments


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