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General NPI Number Information
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NPI Number | 1871852111
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Entity Type | Individual
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Provider Name | JOANNA KATHERINE LEBANS NP
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Gender | Female
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Dates
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Enumeration Date | 05/07/2012
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Last Update Date | 05/07/2012
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Provider Practice Location Address
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Address Line | 18300 ROSCOE BLVD
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City | NORTHRIDGE
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State | CA
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Zip | 91325-4105
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Country | US
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Telephone | 818-885-8500
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Fax |
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Provider Business Mailing Address
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Address Line | 4735 FIRMAMENT AVE
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City | ENCINO
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State | CA
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Zip | 91436-1603
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Country | US
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Telephone | 818-885-8500
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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 | 21164
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License Number State | CA
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