Individual
MS. AMY Y PEARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
1510 SAN PABLO ST, SUITE 200, LOS ANGELES, CA 90033-5320
(323) 442-5908
Mailing address
PO BOX 31309, LOS ANGELES, CA 90031-0309
(323) 442-5908
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
19175
CA
363LA2100X
Acute Care Nurse Practitioner
19175
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1821322124
—
CA
01
—
NP0191750
BLUE SHIELD PROVIDER NUMBER
CA
Enumeration date
09/21/2009
Last updated
11/27/2023
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