Provider Demographics
NPI:1720660848
Name:LEGASPI, CHEANN (NP)
Entity type:Individual
Prefix:
First Name:CHEANN
Middle Name:
Last Name:LEGASPI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CHEANN CLARE
Other - Middle Name:TORRES
Other - Last Name:LEGASPI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:1968 S COAST HWY STE 5195
Mailing Address - Street 2:
Mailing Address - City:LAGUNA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92651-3681
Mailing Address - Country:US
Mailing Address - Phone:657-229-4010
Mailing Address - Fax:562-278-0322
Practice Address - Street 1:520 N MAIN ST STE 220
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-4623
Practice Address - Country:US
Practice Address - Phone:714-352-5800
Practice Address - Fax:714-352-5801
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-27
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95017206363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health