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General NPI Number Information
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NPI Number | 1457057028
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Entity Type | Individual
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Provider Name | LALAINE RUIZ-FORTUNA NASH FNP, RN
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Gender | Female
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Dates
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Enumeration Date | 02/06/2023
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Last Update Date | 02/07/2023
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Provider Practice Location Address
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Address Line | 6210 WINANS DR
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City | LOS ANGELES
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State | CA
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Zip | 90068-2251
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Country | US
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Telephone | 213-841-4165
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Fax |
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Provider Business Mailing Address
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Address Line | 6210 WINANS DR
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City | LOS ANGELES
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State | CA
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Zip | 90068-2251
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Country | US
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Telephone | 213-841-4165
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95023943
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License Number State | CA
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