Provider Demographics
NPI:1902518699
Name:SENIOR, LATOYA CELINE (NP)
Entity Type:Individual
Prefix:
First Name:LATOYA
Middle Name:CELINE
Last Name:SENIOR
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1127 S SPAULDING AVE # 203
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90019-2411
Mailing Address - Country:US
Mailing Address - Phone:424-527-9784
Mailing Address - Fax:
Practice Address - Street 1:1127 S SPAULDING AVE # 203
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90019-2411
Practice Address - Country:US
Practice Address - Phone:424-527-9784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-14
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95023620363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily