Individual
DESARAI LA BOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4445 BURNS AVE, LOS ANGELES, CA 90029-2702
(323) 222-1440
Mailing address
4445 BURNS AVE, LOS ANGELES, CA 90029-2702
(323) 222-1440
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
164X00000X
Licensed Vocational Nurse
Primary
757877
CA
Other
Enumeration date
05/28/2020
Last updated
01/29/2026
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