Healthcare Provider Details

I. General information

NPI: 1245249812
Provider Name (Legal Business Name): LYNDA ANNE STOODLEY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 09/18/2024
Certification Date: 09/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2841 LOMITA BLVD. SUITE 100
TORRANCE CA
90505
US

IV. Provider business mailing address

2841 LOMITA BLVD. SUITE 100
TORRANCE CA
90505
US

V. Phone/Fax

Practice location:
  • Phone: 310-257-0508
  • Fax: 310-325-8109
Mailing address:
  • Phone: 310-257-0508
  • Fax: 310-325-8109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number442946
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number13341
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: