Individual
BERTHA ALICIA LAGEOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
757 WESTWOOD PLZ, PEDIATRIC INTENSIVE CARE UNIT, RRUCLA, LOS ANGELES, CA 90095-8358
(310) 267-7540
Mailing address
5533 SPANISH OAK LN UNIT E, OAK PARK, CA 91377-3730
(818) 991-9439
Taxonomy
Speciality
Code
Description
License number
State
363LP0222X
Critical Care Pediatric Nurse Practitioner
Primary
9490
CA
Other
Enumeration date
09/19/2014
Last updated
09/19/2014
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