Individual
EMILY PANICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, NP, CNS
Contact information
Practice address
11080 W OLYMPIC BLVD, LOS ANGELES, CA 90064-1937
(310) 966-6521
Mailing address
11080 W OLYMPIC BLVD, LOS ANGELES, CA 90064-1937
(310) 966-6515
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
685498
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
18456
CA
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
3222
CA
Other
Enumeration date
03/17/2008
Last updated
10/08/2009
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