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General NPI Number Information
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NPI Number | 1255459129
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Entity Type | Individual
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Provider Name | EVELYN MARCIA DESSER RN, MN, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 11/26/2024
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Provider Practice Location Address
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Address Line | 593 W 6TH ST
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City | SAN PEDRO
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State | CA
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Zip | 90731-2521
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Country | US
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Telephone | 310-547-0202
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Fax | 310-547-5096
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Provider Business Mailing Address
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Address Line | 5412 JANISANN AVE
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City | CULVER CITY
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State | CA
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Zip | 90230-5307
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Country | US
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Telephone | 310-621-1104
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Fax | 310-398-3611
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN347980
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | RN347980
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License Number State | CA
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