Healthcare Provider Details

I. General information

NPI: 1699313320
Provider Name (Legal Business Name): ALVIN WAYNE NAPOLEON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2019
Last Update Date: 12/12/2019
Certification Date: 12/12/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 BAUCHET ST
LOS ANGELES CA
90012-2907
US

IV. Provider business mailing address

450 BAUCHET ST
LOS ANGELES CA
90012-2907
US

V. Phone/Fax

Practice location:
  • Phone: 213-473-2920
  • Fax:
Mailing address:
  • Phone: 213-840-1118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number476853
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: