Healthcare Provider Details

I. General information

NPI: 1407416837
Provider Name (Legal Business Name): LAKPA L SHERPA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2019
Last Update Date: 07/08/2021
Certification Date: 07/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 LONG BEACH BLVD
LONG BEACH CA
90807-2007
US

IV. Provider business mailing address

2118 ROCKEFELLER LN APT B
REDONDO BEACH CA
90278-3666
US

V. Phone/Fax

Practice location:
  • Phone: 562-924-9618
  • Fax:
Mailing address:
  • Phone: 215-279-3575
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95011569
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number95011569
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: