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General NPI Number Information
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NPI Number | 1356815641
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Entity Type | Individual
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Provider Name | HARINI DELIA KOKO AGNP-C
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Gender | Female
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Dates
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Enumeration Date | 01/20/2019
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Last Update Date | 06/14/2022
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Provider Practice Location Address
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Address Line | 2 MELA LN
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City | RANCHO PALOS VERDES
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State | CA
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Zip | 90275-5078
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Country | US
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Telephone | 636-248-9722
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Fax |
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Provider Business Mailing Address
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Address Line | 10000 LAKEWOOD BLVD
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City | DOWNEY
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State | CA
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Zip | 90240-4020
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Country | US
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Telephone | 562-360-6039
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 2018038105
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License Number State | MO
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