Healthcare Provider Details

I. General information

NPI: 1962715060
Provider Name (Legal Business Name): PHYLLIS L. DEMONTE-BARNES N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PHYLLIS LUCILLE DEMONTE-BARNES N.P.

II. Dates (important events)

Enumeration Date: 07/17/2010
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24329 CRENSHAW BLVD STE A
TORRANCE CA
90505-5335
US

IV. Provider business mailing address

24329 CRENSHAW BLVD STE A
TORRANCE CA
90505-5335
US

V. Phone/Fax

Practice location:
  • Phone: 310-868-8100
  • Fax: 310-919-1800
Mailing address:
  • Phone: 310-868-8100
  • Fax: 310-919-1800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number18591
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberNP18591
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: