Healthcare Provider Details

I. General information

NPI: 1649181132
Provider Name (Legal Business Name): KIRSTEN LA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 FIVEPOINT
IRVINE CA
92618-2377
US

IV. Provider business mailing address

1000 FIVEPOINT
IRVINE CA
92618-2377
US

V. Phone/Fax

Practice location:
  • Phone: 949-659-8442
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH61148
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1835I0206X
TaxonomyInfectious Diseases Pharmacist
License NumberRPH61148
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: