Individual
ANISSA Y LACOUNT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9985 SIERRA AVE, KAISER PERMANENTE HUMAN RESOURCES, FONTANA, CA 92335-6720
(909) 382-7100
(909) 382-7136
Mailing address
9985 SIERRA AVE, PERMANENTE HUMAN RESOURCES, FONTANA, CA 92335-6720
(909) 427-7132
(909) 427-5033
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A78550
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A78550
EXPANDED ACCESS TO PRIMAR
CA
05
—
00A87550
—
CA
01
—
F142463
INLAND EMPIRE HEALTH PLAN
CA
01
—
L082463
INLAND EMPIRE HEALTH PLAN
CA
01
—
MOLINA
MOLINA HEALTH CARE
CA
Enumeration date
01/04/2006
Last updated
12/03/2021
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