Healthcare Provider Details

I. General information

NPI: 1033912381
Provider Name (Legal Business Name): MADELEINE LEIGH LABRECQUE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5901 W OLYMPIC BLVD STE 505
LOS ANGELES CA
90036-4670
US

IV. Provider business mailing address

12 VEAZY CIR
BRENTWOOD NH
03833-6643
US

V. Phone/Fax

Practice location:
  • Phone: 323-930-2324
  • Fax:
Mailing address:
  • Phone: 603-617-9973
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF08240811
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License Number95308743
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: