Basic Information
| Provider Information | |||||||||
| NPI: | 1538687462 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LAROSE | ||||||||
| FirstName: | LAURA | ||||||||
| MiddleName: | BETH BITTNER | ||||||||
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| Credential: | RN-BC, MSN, OCN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1029 2ND ST APT 205 | ||||||||
| Address2: | |||||||||
| City: | SANTA MONICA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 904033616 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8603280426 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2021 SANTA MONICA BLVD STE 400E | ||||||||
| Address2: | |||||||||
| City: | SANTA MONICA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 904042103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3104535654 | ||||||||
| FaxNumber: | 3104536885 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2017 | ||||||||
| LastUpdateDate: | 04/16/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/16/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WX0200X | 812892 | CA | N | Nursing Service Providers | Registered Nurse | Oncology | 363LA2100X | 95006980 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
No ID Information.