Individual
CALISTA E EZEOKOYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2917 W VERNON AVE # B, LOS ANGELES, CA 90008-4714
(323) 426-5200
Mailing address
1338 E DENWALL DR STE 200, CARSON, CA 90746-3156
(323) 426-5200
(323) 426-5252
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
95003322
CA
363LF0000X
Family Nurse Practitioner
95003322
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95003322
CA
Other
Enumeration date
04/05/2016
Last updated
05/03/2023
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