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General NPI Number Information
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NPI Number | 1275704587
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Entity Type | Individual
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Provider Name | JOSEPHINE ARCILLA EVANGELISTA ARNP
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Gender | Female
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Dates
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Enumeration Date | 03/13/2008
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Last Update Date | 06/04/2024
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Provider Practice Location Address
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Address Line | 2020 SANTA MONICA BLVD STE 600
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City | SANTA MONICA
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State | CA
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Zip | 90404-2131
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Country | US
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Telephone | 310-826-5471
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Fax |
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Provider Business Mailing Address
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Address Line | 5767 W CENTURY BLVD STE 400
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City | LOS ANGELES
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State | CA
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Zip | 90045-5631
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Country | US
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Telephone | 310-301-8707
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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 | RN60338171
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN60338171
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | NP 15984
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP60338791
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License Number State | WA
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Taxonomy #5
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 15984
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License Number State | CA
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