Provider Demographics
NPI:1972357580
Name:KONARAKI, LALA (FNP)
Entity Type:Individual
Prefix:MS
First Name:LALA
Middle Name:
Last Name:KONARAKI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 N EVERGREEN ST
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-1708
Mailing Address - Country:US
Mailing Address - Phone:818-424-0770
Mailing Address - Fax:
Practice Address - Street 1:517 E WILSON AVE STE 103
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-4359
Practice Address - Country:US
Practice Address - Phone:888-625-2459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-11
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95029122374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula