Individual provider · Type 1 NPI
Jason Bombales Lasala, NP
Psychiatric/Mental Health Nurse Practitioner · Gardena, CA
NPI number
1821744178
Active
Practice location
1225 W 190th St Ste 280
Gardena, CA 90248-4305
Fax (310) 538-2102
Other practice locations
- 438 W Las Tunas Dr, San Gabriel, CA 91776-1216 · (626) 289-5454
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 95018499 (CA) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1821744178
Jason Bombales Lasala, NP's National Provider Identifier is 1821744178, issued on Feb 25, 2022. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Gardena, CA. The record was last updated on Jul 19, 2022.