Healthcare Provider Details

I. General information

NPI: 1811881873
Provider Name (Legal Business Name): ANA LETICIA PERLY SAKURAI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LETICIA SAKURAI CLC

II. Dates (important events)

Enumeration Date: 06/04/2025
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1337 WARNALL AVE
LOS ANGELES CA
90024-5355
US

IV. Provider business mailing address

1337 WARNALL AVE
LOS ANGELES CA
90024-5355
US

V. Phone/Fax

Practice location:
  • Phone: 323-576-3055
  • Fax:
Mailing address:
  • Phone: 323-576-3055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: