Provider Demographics
NPI:1245519172
Name:LASH, PATRICIA THALKEN (FNP)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:THALKEN
Last Name:LASH
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:P.O.BOX 3699
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92659-3699
Mailing Address - Country:US
Mailing Address - Phone:714-668-2500
Mailing Address - Fax:714-668-2515
Practice Address - Street 1:1190 BAKER STREET
Practice Address - Street 2:100
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92659
Practice Address - Country:US
Practice Address - Phone:714-668-2500
Practice Address - Fax:714-668-2515
Is Sole Proprietor?:No
Enumeration Date:2011-08-09
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20933363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily