Healthcare Provider Details
I. General information
NPI: 1205022175
Provider Name (Legal Business Name): LA CHUNE F PRICE PHYSICIAN ASSISTANT
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/24/2007
Last Update Date: 05/23/2025
Certification Date: 05/23/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2030 W PICO BLVD
LOS ANGELES CA
90006-5011
US
IV. Provider business mailing address
2080 CENTURY PARK E STE 1206
LOS ANGELES CA
90067-2015
US
V. Phone/Fax
- Phone: 213-389-4544
- Fax: 213-389-4554
- Phone: 213-389-4544
- Fax: 213-389-4554
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106E00000X |
| Taxonomy | Assistant Behavior Analyst |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363AM0700X |
| Taxonomy | Medical Physician Assistant |
| License Number | PA19206 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: