Healthcare Provider Details

I. General information

NPI: 1902499858
Provider Name (Legal Business Name): VICTORIA MAE LACHAPELL NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2021
Last Update Date: 03/31/2021
Certification Date: 03/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 W BALL RD STE 202
ANAHEIM CA
92804-3735
US

IV. Provider business mailing address

1014 GEORGIA ST UNIT 204
HUNTINGTON BEACH CA
92648-4394
US

V. Phone/Fax

Practice location:
  • Phone: 714-236-9663
  • Fax:
Mailing address:
  • Phone: 406-350-1284
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number844145
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95017054
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: