Healthcare Provider Details

I. General information

NPI: 1437676368
Provider Name (Legal Business Name): VANESA LOVATO RN, NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2017
Last Update Date: 11/26/2024
Certification Date: 11/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4425 S CENTRAL AVE
LOS ANGELES CA
90011-3629
US

IV. Provider business mailing address

4425 S CENTRAL AVE
LOS ANGELES CA
90011-3629
US

V. Phone/Fax

Practice location:
  • Phone: 323-908-4200
  • Fax: 323-985-9940
Mailing address:
  • Phone: 323-908-4200
  • Fax: 323-985-9940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95014177
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WG0100X
TaxonomyGastroenterology Registered Nurse
License Number851796
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: