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General NPI Number Information
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NPI Number | 1346030418
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Entity Type | Organization
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Legal Business Name | RL PRIMARY NURSING CARE CLINIC INC
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Dates
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Enumeration Date | 05/10/2025
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Last Update Date | 09/29/2025
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Provider Practice Location Address
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Address Line | 15366 11TH ST
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City | VICTORVILLE
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State | CA
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Zip | 92395-3726
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Country | US
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Telephone | 442-414-2469
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Fax |
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Provider Business Mailing Address
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Address Line | 8605 SANTA MONICA BLVD
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90069-4109
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Country | US
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Telephone | 442-414-2469
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | MISS LISA ROGERS
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Credential | DNP
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Telephone | 442-414-2469
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LC0200X
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Taxonomy Name | Critical Care Medicine Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number |
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License Number State |
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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 |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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