Provider Demographics
NPI:1295533297
Name:LIVSHITS, YELENA (NP)
Entity type:Individual
Prefix:
First Name:YELENA
Middle Name:
Last Name:LIVSHITS
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:924 N GENESEE AVE APT 8
Mailing Address - Street 2:
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90046-7345
Mailing Address - Country:US
Mailing Address - Phone:323-610-1025
Mailing Address - Fax:
Practice Address - Street 1:924 N GENESEE AVE APT 8
Practice Address - Street 2:
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90046-7345
Practice Address - Country:US
Practice Address - Phone:323-610-1025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95034192363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily