Healthcare Provider Details

I. General information

NPI: 1902460447
Provider Name (Legal Business Name): JESSICA LAPWORTH DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2019
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4447 CANDLEWOOD ST
LAKEWOOD CA
90712-1736
US

IV. Provider business mailing address

4447 CANDLEWOOD ST
LAKEWOOD CA
90712-1736
US

V. Phone/Fax

Practice location:
  • Phone: 657-241-9935
  • Fax: 657-276-4736
Mailing address:
  • Phone: 657-241-9935
  • Fax: 657-276-4736

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number20A21251
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: