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General NPI Number Information
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NPI Number | 1699187484
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Entity Type | Organization
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Legal Business Name | LOS ANGELES UNIFIED SCHOOL DISTRICT
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Dates
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Enumeration Date | 05/28/2014
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Last Update Date | 05/28/2014
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Provider Practice Location Address
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Address Line | 121 N BEAUDRY AVE
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City | LOS ANGELES
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State | CA
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Zip | 90012-2009
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Country | US
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Telephone | 213-202-7533
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Fax | 213-580-6557
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Provider Business Mailing Address
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Address Line | 121 N BEAUDRY AVE
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City | LOS ANGELES
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State | CA
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Zip | 90012-2009
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Country | US
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Telephone | 213-202-7533
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Fax | 213-580-6557
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Authorized Official
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Title or Position | LEAD NURSE PRACTITIONER
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Name | MS. ROBERTA VILLANUEVA
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Credential | NP
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Telephone | 213-202-7533
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 23764
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License Number State | CA
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