=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558234906
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALANA BACKSTROM
-----------------------------------------------------
Gender |
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/23/2025
-----------------------------------------------------
Last Update Date | 09/23/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5015 WHITTIER BLVD
-----------------------------------------------------
City | EAST LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90022-3116
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 323-268-9191
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2700 TERRAZA PL
-----------------------------------------------------
City | FULLERTON
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92835-2462
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 95034767
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------