Provider Demographics
NPI:1346548310
Name:SMITH-FAVORS, LASHAUN (DNP, MSN, FNP)
Entity Type:Individual
Prefix:DR
First Name:LASHAUN
Middle Name:
Last Name:SMITH-FAVORS
Suffix:
Gender:F
Credentials:DNP, MSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 E ALESSANDRO BLVD STE A-262
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92508-5084
Mailing Address - Country:US
Mailing Address - Phone:951-789-2270
Mailing Address - Fax:
Practice Address - Street 1:231 E ALESSANDRO BLVD STE A-262
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92508-5084
Practice Address - Country:US
Practice Address - Phone:951-789-2270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-01
Last Update Date:2012-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19141363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily