Individual
LAKEIIA RAE'CHELLE PENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17508 SCUDDER CT, CARSON, CA 90746-1651
(323) 707-3661
Mailing address
17508 SCUDDER CT, CARSON, CA 90746-1651
(323) 707-3661
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95032332
CA
Other
Enumeration date
10/03/2024
Last updated
10/03/2024
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