Individual
LY NGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
550 S VERMONT AVE, LOS ANGELES, CA 90020-1912
(213) 972-7046
Mailing address
510 S VERMONT AVE, LOS ANGELES, CA 90020-1992
(213) 408-6340
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
819758
CA
Other
Enumeration date
04/14/2017
Last updated
11/04/2021
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