Individual
MRS. MICHELLE BASA LLERENAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
757 WESTWOOD PLZ, LOS ANGELES, CA 90095-8358
(310) 267-7565
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
(310) 267-7565
Taxonomy
Speciality
Code
Description
License number
State
163WN0002X
Neonatal Intensive Care Registered Nurse
759587
CA
363LN0000X
Neonatal Nurse Practitioner
Primary
95022072
CA
363LN0005X
Critical Care Neonatal Nurse Practitioner
95022072
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
759587
BOARD OF REGISTERED NURSING
CA
Enumeration date
04/15/2020
Last updated
01/03/2023
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