Healthcare Provider Details

I. General information

NPI: 1912093774
Provider Name (Legal Business Name): FELICIA N OSBORN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 09/28/2024
Certification Date: 09/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 S GRAND AVE
LOS ANGELES CA
90015-3010
US

IV. Provider business mailing address

5131 VERDURA AVE
LAKEWOOD CA
90712-2225
US

V. Phone/Fax

Practice location:
  • Phone: 213-742-5728
  • Fax:
Mailing address:
  • Phone: 310-927-8179
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number9777
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number515342
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: