Healthcare Provider Details

I. General information

NPI: 1609213776
Provider Name (Legal Business Name): TRINITY HARRIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2013
Last Update Date: 02/06/2025
Certification Date: 02/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5220 W WASHINGTON BLVD
LOS ANGELES CA
90016-1331
US

IV. Provider business mailing address

5220 W WASHINGTON BLVD
LOS ANGELES CA
90016-1331
US

V. Phone/Fax

Practice location:
  • Phone: 725-219-5009
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: