Provider Demographics
NPI:1124253323
Name:LEDEZMA, BLANCA ARACELI (MSN, NP)
Entity type:Individual
Prefix:MISS
First Name:BLANCA
Middle Name:ARACELI
Last Name:LEDEZMA
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Gender:F
Credentials:MSN, NP
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Mailing Address - Street 1:2020 SANTA MONICA BLVD
Mailing Address - Street 2:SUTIE 600
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404
Mailing Address - Country:US
Mailing Address - Phone:310-289-5471
Mailing Address - Fax:310-829-6192
Practice Address - Street 1:2020 SANTA MONICA BLVD
Practice Address - Street 2:SUTIE 600
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404
Practice Address - Country:US
Practice Address - Phone:310-289-5471
Practice Address - Fax:310-829-6192
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-18
Last Update Date:2013-02-27
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Provider Licenses
StateLicense IDTaxonomies
CA570758363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner