Provider Demographics
NPI:1033512595
Name:FALARDEAU, DENISE LEE (NP)
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:LEE
Last Name:FALARDEAU
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:PO BOX 512185
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90051-0185
Mailing Address - Country:US
Mailing Address - Phone:626-775-3514
Mailing Address - Fax:626-218-5310
Practice Address - Street 1:1500 DUARTE RD
Practice Address - Street 2:MACHRIS 2101
Practice Address - City:DUARTE
Practice Address - State:CA
Practice Address - Zip Code:91010-3012
Practice Address - Country:US
Practice Address - Phone:626-471-9200
Practice Address - Fax:626-218-0188
Is Sole Proprietor?:No
Enumeration Date:2014-09-29
Last Update Date:2020-12-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MARN2285119363L00000X
CA1033512595363LA2200X
CA95004253363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health