Provider Demographics
NPI:1215914577
Name:LOTHO, JOCELYN (NP)
Entity type:Individual
Prefix:MS
First Name:JOCELYN
Middle Name:
Last Name:LOTHO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:JOCELYN
Other - Middle Name:L
Other - Last Name:SANCHEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:1430 SAN JULIAN ST # 2
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90015-3142
Mailing Address - Country:US
Mailing Address - Phone:213-765-2821
Mailing Address - Fax:
Practice Address - Street 1:1430 SAN JULIAN ST # 2
Practice Address - Street 2:LOS ANGELES SCHOOL DISTRICT
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90015-3142
Practice Address - Country:US
Practice Address - Phone:213-765-2821
Practice Address - Fax:213-765-3861
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-28
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA545807363LS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LS0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerSchool