Healthcare Provider Details

I. General information

NPI: 1114318896
Provider Name (Legal Business Name): STEPHANIE NGSEE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2015
Last Update Date: 11/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 E SLAUSON AVE
HUNTINGTON PARK CA
90255-2725
US

IV. Provider business mailing address

1900 E SLAUSON AVE
HUNTINGTON PARK CA
90255-2725
US

V. Phone/Fax

Practice location:
  • Phone: 323-487-4110
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number23843
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: