Provider Demographics
NPI:1871364596
Name:WHITE, LA RONCI MICHELE
Entity type:Individual
Prefix:
First Name:LA RONCI
Middle Name:MICHELE
Last Name:WHITE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 E TAMARACK AVE APT 6
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90301-6272
Mailing Address - Country:US
Mailing Address - Phone:310-928-5968
Mailing Address - Fax:
Practice Address - Street 1:316 E TAMARACK AVE APT 6
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-6272
Practice Address - Country:US
Practice Address - Phone:310-928-5968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-11
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA203566164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse