Individual
SIEM IA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
200 UCLA MEDICAL PLZ, STE 265, LOS ANGELES, CA 90095
(310) 206-0514
Mailing address
5767 W CENTURY BLVD, SUITE 400, LOS ANGELES, CA 90045-5631
(310) 206-0514
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
21729
CA
Other
Enumeration date
08/14/2012
Last updated
04/01/2013
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