Provider Demographics
NPI:1144950296
Name:SANTOS, LAMOURA-ALEXIS M (RN)
Entity type:Individual
Prefix:MRS
First Name:LAMOURA-ALEXIS
Middle Name:M
Last Name:SANTOS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:LAMOURA-ALEXIS
Other - Middle Name:MALLARE
Other - Last Name:AGUILAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:27084 AMBER SKY WAY
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91381-2113
Mailing Address - Country:US
Mailing Address - Phone:805-405-7925
Mailing Address - Fax:
Practice Address - Street 1:510 S VERMONT AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-1992
Practice Address - Country:US
Practice Address - Phone:800-854-7771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-13
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95028611163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse