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General NPI Number Information
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NPI Number | 1588436844
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Entity Type | Organization
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Legal Business Name | LATESHA REED NURSE PRACTITIONER A NURSING CORPORATION
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Dates
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Enumeration Date | 10/30/2023
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 5304 SENFORD AVE
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City | LOS ANGELES
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State | CA
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Zip | 90056-1027
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Country | US
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Telephone | 310-853-2395
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Fax |
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Provider Business Mailing Address
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Address Line | 400 CORPORATE POINTE STE 300
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City | CULVER CITY
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State | CA
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Zip | 90230
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Country | US
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Telephone | 310-853-2395
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Fax | 203-902-0115
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Authorized Official
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Title or Position | CEO
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Name | DR. LATESHA TIFFANY REED
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Credential | DNP, FNP, PMHNP
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Telephone | 310-853-2395
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health 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 | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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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 | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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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 | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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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 | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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