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Individual

TRISH VANESSA WILLIAMS FORDE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3415 S SEPULVEDA BLVD STE 1100, LOS ANGELES, CA 90034-7090
(310) 881-2700
Mailing address
3415 S SEPULVEDA BLVD STE 1100, LOS ANGELES, CA 90034-7090
(310) 881-2700

Taxonomy

Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
829012
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95019273
CA

Other

Enumeration date
08/28/2018
Last updated
12/04/2021
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