NPIViewer - Provider NPI 1972065001

Provider Demographics

NPI:	1972065001
Name:	LA LAKERS
Entity type:	Organization
Organization Name:	LA LAKERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:	HEALTHCARE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:	RAVEN
Authorized Official - Middle Name:	SHENETTE
Authorized Official - Last Name:	MAYES
Authorized Official - Suffix:
Authorized Official - Credentials:	DO
Authorized Official - Phone:	352-792-8069
Mailing Address - Street 1:	2101 NE 2ND ST APT 114
Mailing Address - Street 2:
Mailing Address - City:	GAINESVILLE
Mailing Address - State:	FL
Mailing Address - Zip Code:	32609-8626
Mailing Address - Country:	US
Mailing Address - Phone:	352-792-8069
Mailing Address - Fax:
Practice Address - Street 1:	2101 NE 2ND ST APT 114
Practice Address - Street 2:
Practice Address - City:	GAINESVILLE
Practice Address - State:	FL
Practice Address - Zip Code:	32609-8626
Practice Address - Country:	US
Practice Address - Phone:	352-792-8069
Practice Address - Fax:
EIN:	<UNAVAIL>
Is Organization Subpart?:	Yes
Parent Organization LBN:	000018
Parent Organization TIN:	<UNAVAIL>
Enumeration Date:	2019-04-06
Last Update Date:	2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:

Provider Taxonomies

Primary?	Code	Type	Classification	Group
Yes	252Y00000X	Agencies	Early Intervention Provider Agency
Yes	282N00000X	Hospitals	General Acute Care Hospital	Group - Multi-Specialty
No	174200000X	Other Service Providers	Meals
No	251300000X	Agencies	Local Education Agency (LEA)
No	251B00000X	Agencies	Case Management
No	261Q00000X	Ambulatory Health Care Facilities	Clinic/Center
No	282J00000X	Hospitals	Religious Nonmedical Health Care Institution
No	284300000X	Hospitals	Special Hospital
No	286500000X	Hospitals	Military Hospital
No	314000000X	Nursing & Custodial Care Facilities	Skilled Nursing Facility
No	331L00000X	Suppliers	Blood Bank
No	333600000X	Suppliers	Pharmacy
No	347C00000X	Transportation Services	Private Vehicle
No	251J00000X	Agencies	Nursing Care

Provider Identifiers

State	Identifier ID	ID Type	Issuer
DC	1324114-11-26-2010	Other	VISN 8 DIVERSITY TRAINING
DC	1339073-10-01-2009	Other	BLS (BASIC LIFE SUPPORT) HEALTHCARE PROVIDER
DC	1339076-10-01-2009	Other	BLS (BASIC LIFE SUPPORT) HEALTHCARE PROVIDER CHALLENGE
DC	1337502-11-26-2010	Other	RIGHT SIDED EKG
DC	32432-07-14-2008	Other	VHA PROVIDER PRIVACY TRAINING
DC	13220-504136-2010	Other	ORAL & WRITTEN COMMUNICATION
DC	1324114-11-26-2010	Other	VISN 8 DIVERSITY TRAINING
DC	1333993-11-26-2010	Other	MAND: CULTURALLY COMPETENT HEALTH CARE
DC	1337014-11-26-2010	Other	HIV/AIDS
DC	1337161-01-26-2011	Other	MAND: PATIENT SAFETY
DC	1337523-12-01-2010	Other	WOMEN VETERANS COMPETENCY
DC	5424-01-18-2011	Other	INTEGRATEDETHICS - ETHICS IN HEALTH CARE
DC	565-03-12-2009-32609	Other	NO FEAR (NOTIFICATION & FEDERAL EMPLOYEE ANTIDISCRIMINATION & RETALIATION) ACT
NJ	0122-2918-32609	Other	OCULAR SUFACE DISEASES DISORDERS AND DYFUNTIOINS VOLUME 4 NUMBER 3
DC	1339076-10-01-2009	Other	BLS (BASIC LIFE SUPPORT) HEALTHCARE PROVIDER CHALLENGE
DC	2056992-08-02-2011	Other	MIA VA MISSION, CORE VALUES AND CHARACTERISTICS
DC	1337011-11-26-2010	Other	DOMESTIC VIOLENCE FBN2285
NJ	0116-2918-32609	Other	36 YR OLD WOMAN SHOB SHORTNESS OF BREATH WEEZING
NJ	0116-2918-32609	Other	ADVANCING SCIENCE IN RESIDUAL CARDIOVASCULAR OUT COMES TRIALS PARADGM PT. CARE
	0116-2918-32609	Other	OPIOD DISORDER MOVING BEYOND STATUS QUO
DC	1322049-503742-2010	Other	CRITICAL THINKING
DC	1332127-10-01-2010	Other	MAND: AGE SPECIFIC
DC	1337502-11-26-2010	Other	RIGHT SIDED EKG
DC	789931-05-05-2009	Other	STRUCTURING, EDITING, SAVING, AND OPENING DOCUMENTS IN WORD 2007
OH	OBN-006-92	Other	NURSING LAW AND RULES
NJ	0122-2918-32609	Other	BEST IBD FORUM 2018
DC	1333992-11-26-2010	Other	MAND: ALTERNATE DISPUTE RESOLUTION
DC	1334007-01-26-2011	Other	MAND: PREVENTION OF WORKPLACE VIOLENCE
DC	32755-07-15-2010	Other	GENERAL EMPLOYEE PRIVACY AWARENESS
DC	0103-2918-32609	Other	ECG RHYTHM UPDATE
DC	0103-2918-32609	Other	EKG COMPREHESIVE CLINICAL SKILLS UPDATE
DC	1334002-01-18-2011	Other	MAND: INFECTION CONTROL
DC	1334004-01-26-2011	Other	MAND: NATIONAL PATIENT SAFETY GOALS
DC	32432-07-14-2008	Other	VHA PROVIDER PRIVACY TRAINING
DC	7318-06-21-2010	Other	COMPLIANCE AND BUSINESS INTEGRITY (CBI) AWARENESS MANDATORY EDUCATION COURSE
DC	77439-03-12-2009	Other	PROTECTED PEER REVIEW PROCESS FOR ALL CLINICAL PROVIDERS
DC	0103-2918-32609	Other	ECG PATIENT MONITOR CLINICAL SKILL UPDATE
NJ	0214-2303-32640	Other	PROGRESSIVE PATHWAYS IN TREATING NEOVASCULAR RETINAL DISASE EXPLORING TIE2
DC	1322056-503640-2010	Other	PROBLEM SOLVING AND DECISION MAKING
DC	1334000-01-18-2011	Other	MAND: HAZARDOUS MATERIAL AND WASTES
DC	1337521-01-26-2011	Other	UNIQUE ASPECTS OF WOMEN'S HEALTH CARE FBN2285
DC	1339073-10-01-2009	Other	BLS (BASIC LIFE SUPPORT) HEALTHCARE PROVIDER
DC	66979-05-27-2009	Other	SUICIDE PREVENTION GUIDE TRAINING (S.A.V.E.)
NJ	0116-2918-32609	Other	ANTIVIRAL AGENTS INFLUENZING CLINICAL PRACTICE
NJ	0116-2918-32609	Other	63 YR OLD MAN PRESENT ER WITH GENERILIZED WEAKNESS LOSS OF APPETITE
CO	0122-2918-32609	Other	NEW OPTIONS TO REDUCE CARDIOVASCULAR EVENTS IN ASCVD
DC	10176-03-12-2009	Other	VA PRIVACY AND INFORMATION SECURITY AWARENESS AND RULES OF BEHAVIOR
DC	1333999-01-18-2011	Other	MAND: FIRE AND SAFETY
DC	1334009-11-26-2010	Other	MAND: EEO
DC	5506-03-12-2009	Other	PREVENTION OF SEXUAL HARASSMENT

Provider Demographics

Provider Taxonomies

Provider Identifiers

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