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Individual

MRS. LESLIE CHANG EVERTSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
N.P.

Contact information

Practice address
1245 16TH ST, SUITE 208, SANTA MONICA, CA 90404-1235
(310) 825-8253
(310) 319-4141
Mailing address
3666 VALENCIA AVE, SIMI VALLEY, CA 93063-2223
(805) 522-3666

Taxonomy

Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
16341
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1235141078
CA
Enumeration date
08/12/2006
Last updated
02/28/2013
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