| NPI | 1548905391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYISHA RENEE FLETCHER Nurse Practitioner 310-251-6727 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2022-05-04 |
| Last Update Date | 2022-12-29 |