Provider Demographics
NPI:1740096189
Name:MASON, LAKESHIA ANN (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:LAKESHIA
Middle Name:ANN
Last Name:MASON
Suffix:
Gender:
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:626 W LANCASTER BLVD STE 51
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-3108
Mailing Address - Country:US
Mailing Address - Phone:213-557-8303
Mailing Address - Fax:
Practice Address - Street 1:626 W LANCASTER BLVD STE 51
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-3108
Practice Address - Country:US
Practice Address - Phone:213-557-8303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-10
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95032943363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health