Provider Demographics
NPI:1033908736
Name:BASS, LUMINTA BEATRICE (RN)
Entity type:Individual
Prefix:
First Name:LUMINTA
Middle Name:BEATRICE
Last Name:BASS
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:LUMINITA
Other - Middle Name:BEATRICE
Other - Last Name:MESESAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 290
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90801-0290
Mailing Address - Country:US
Mailing Address - Phone:818-539-7272
Mailing Address - Fax:818-539-7586
Practice Address - Street 1:14536 ROSCOE BLVD STE 101
Practice Address - Street 2:
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402-4103
Practice Address - Country:US
Practice Address - Phone:818-539-7272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA754954163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator