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Individual

PATRICIA MCCOY EDLEFSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MN MASTER OF NURSING

Contact information

Practice address
12304 SANTA MONICA BLVD, SUITE #106, LOS ANGELES, CA 90025
(310) 578-5537
Mailing address
5399 BLANCO WAY, CULVER CITY, CA 90230
(310) 390-5756

Taxonomy

Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN186184
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
331
CA BOARD OF REG NRS
01
PMH 410
CONSUMER AFFAIRS
CA
Enumeration date
02/05/2007
Last updated
07/08/2007
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