Healthcare Provider Details

I. General information

NPI: 1891527552
Provider Name (Legal Business Name): JANA LAUREN SACKETT PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JANA LAUREN KLEMEN

II. Dates (important events)

Enumeration Date: 08/20/2024
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

714 W OLYMPIC BLVD STE 703
LOS ANGELES CA
90015-1439
US

IV. Provider business mailing address

714 W OLYMPIC BLVD STE 703
LOS ANGELES CA
90015-1439
US

V. Phone/Fax

Practice location:
  • Phone: 213-715-2100
  • Fax:
Mailing address:
  • Phone: 213-715-2100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95031772
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: