Basic Information
Provider Information
NPI: 1326476326
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WHANG
FirstName: LINDSEY
MiddleName: MORALES
NamePrefix: MRS.
NameSuffix:  
Credential: F.N.P
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: MORALES
OtherFirstName: LINDSEY
OtherMiddleName: ALICE
OtherNamePrefix: MS.
OtherNameSuffix:  
OtherCredential: F.N.P
OtherLastNameType: 1
Mailing Information
Address1: 1172 N MACLAY AVE
Address2:  
City: SAN FERNANDO
State: CA
PostalCode: 913401328
CountryCode: US
TelephoneNumber: 8188981388
FaxNumber: 8182709590
Practice Location
Address1: 1172 N MACLAY AVE
Address2:  
City: SAN FERNANDO
State: CA
PostalCode: 913401328
CountryCode: US
TelephoneNumber: 8188981388
FaxNumber: 8182709590
Other Information
ProviderEnumerationDate: 10/29/2013
LastUpdateDate: 04/25/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
164W00000X23836CAY Nursing Service ProvidersLicensed Practical Nurse 

No ID Information.


Home