LARISSA KANEESHA PETERSON NPI 1225506397

NPI Information

  • NPI: 1225506397
  • Provider Name: LARISSA KANEESHA PETERSON
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1180 S BEVERLY DR STE 700
    LOS ANGELES, CA
    ZIP 90035
  • Phone: (424) 334-6288

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NPI Details

Larissa Kaneesha Peterson is a family nurse practitioner in Los Angeles, CA. Larissa Kaneesha Peterson NPI is 1225506397. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1180 S BEVERLY DR STE 700
LOS ANGELES, CA
ZIP 90035-151
Phone: (424) 334-6288

The NPI 1225506397 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/7/2018 and was last updated on 5/8/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamily0024176854VIRGINIANo
2363LF0000XNurse PractitionerFamily95014921CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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