MEDICARE: MS. LETICIA REBECCA HEAL HOPLEY NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	349769	CA
2	363L00000X	Nurse Practitioner	10190	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	NP10190	OTHER	CA	NURSE PRACTITIONER CERTIF
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	RN 349769	OTHER	CA	REGISTERED NURSE LIC

General Provider Information

NPI Number	:	1154520971
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LETICIA REBECCA HEAL HOPLEY NP

Provider Business Mailing Address
First Line	:	1815 GOODMAN AVE
Second Line	:
City	:	REDONDO BEACH
State	:	CA
Zip	:	90278-2722
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1535 S WESTERN AVE
Second Line	:	SUITE G
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-4200
Country	:	US
Telephone Number	:	323-733-1885
Fax Number	:	323-733-1875

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2007
Last Update Date	:	03/16/2012

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