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
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 164W00000X | 23836 | CA | Y |   | Nursing Service Providers | Licensed Practical Nurse |   |
No ID Information.