Healthcare Provider Details

I. General information

NPI: 1154520971
Provider Name (Legal Business Name): LETICIA REBECCA HEAL HOPLEY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2007
Last Update Date: 03/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1535 S WESTERN AVE SUITE G
LOS ANGELES CA
90006-4200
US

IV. Provider business mailing address

1815 GOODMAN AVE
REDONDO BEACH CA
90278-2722
US

V. Phone/Fax

Practice location:
  • Phone: 323-733-1885
  • Fax: 323-733-1875
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number349769
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number10190
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: