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General NPI Number Information
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NPI Number | 1215219365
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Entity Type | Individual
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Provider Name | JESSICA MAY LUM LAU PPCNP-BC, RN
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Gender | Female
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Dates
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Enumeration Date | 09/14/2011
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Last Update Date | 11/12/2019
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Provider Practice Location Address
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Address Line | 15725 WHITTIER BLVD SUITE 250
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City | WHITTIER
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State | CA
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Zip | 90603-2347
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Country | US
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Telephone | 562-947-9399
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Fax |
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Provider Business Mailing Address
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Address Line | 15725 WHITTIER BLVD SUITE 250
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City | WHITTIER
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State | CA
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Zip | 90603-2347
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Country | US
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Telephone | 562-947-9399
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 644977
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 382238
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 21799
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License Number State | CA
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