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General NPI Number Information
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NPI Number | 1427009679
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Entity Type | Individual
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Provider Name | LUANN EVELYN SANDERSON MSN, APRN, BC, CNS
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Gender | Female
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 07/23/2007
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Provider Practice Location Address
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Address Line | 11301 WILSHIRE BLVD MAIL CODE 10H4
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City | LOS ANGELES
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State | CA
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Zip | 90073-1003
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Country | US
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Telephone | 310-478-3711
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Fax |
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Provider Business Mailing Address
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Address Line | 3911 CANDLEWOOD ST
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City | LAKEWOOD
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State | CA
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Zip | 90712-1650
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Country | US
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Telephone |
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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 | 364SP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | 13-67600-022
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License Number State | KS
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