Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | NP18473 | CA |
N | 363LA2100X | Nurse Practitioner - Acute Care | 18473 | CA |
NPI | 1043456924 |
---|---|
Provider Name | Ms. Laura Kathleen Sjoberg |
First Address | Los Angeles, CA 90031-0309 |
Second Address | Los Angeles, CA 90033-5310 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/12/2008 |
Last Update Date | 17/09/2020 |