Shallenberger, Elizabeth

Shallenberger, Elizabeth is an individual health care provider with primary practice located at 1510 San Pabl Street , Los Angeles CA 90033-5320. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Gerontology. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Shallenberger, Elizabeth can be contacted via phone (323) 442-5907.

Contact Information

Primary practice address
1510 San Pabl Street Los Angeles CA 90033-5320
Phone: (323) 442-5907
Fax: (323) 442-6020
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 16796 California
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X 213285 Massachusetts

Profile Details

NPI number 1790880961
LBN Legal business name Shallenberger, Elizabeth
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 13th, 2006
Last updated Apr 17th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790880961 NPPES
Massachusetts MEDICAID 0390071
Massachusetts Other NP2988

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