Healthcare Provider Details

I. General information

NPI: 1023935921
Provider Name (Legal Business Name): ALLISON JOYCE PADUA DE VERA MSN, RN, FNP, PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8700 BEVERLY BLVD
WEST HOLLYWOOD CA
90048-1804
US

IV. Provider business mailing address

6535 HASKELL AVE APT 106
VAN NUYS CA
91406-6124
US

V. Phone/Fax

Practice location:
  • Phone: 805-588-8118
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95022698
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: