LINE ORNELLA FASSUSIANKAM (NPI# 1932646502) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932646502 |
| Entity Type | Individual |
| Full Name | LINE ORNELLA FASSUSIANKAM |
| Practice Address |
4211 Avalon Blvd Los Angeles CA 90011-5622 |
| Practice Telephone | 3232333042 |
| Practice Fax Number | 3232322366 |
| Mailing Telephone | 3232330425 |
| Mailing Fax Number | 3232322366 |
| Enumeration Date | 2017-01-20 |
| Last Update Date | 2017-01-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P1300X |
Pharmacist Specialization: Psychiatric |
76080 | CA | Pharmacy Service Providers |
| Street Address |
4211 AVALON BLVD |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90011-5622 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316034671 | Sohini Parikh | Psychiatry & Neurology | 4211 Avalon Blvd, Los Angeles, CA 90011-5622 | 2006-10-06 |
| 1427659382 | Dana Thomas | Social Worker | 4211 Avalon Blvd, Los Angeles, CA 90011-5622 | 2020-11-05 |
| 1487254488 | Destiny Marie Lara | Case Manager/Care Coordinator | 4211 Avalon Blvd, Los Angeles, CA 90011-5622 | 2020-10-28 |
| 1538767215 | Shira Amiri | Social Worker | 4211 Avalon Blvd, Los Angeles, CA 90011-5622 | 2020-10-14 |
| 1053927301 | Luz Elena Nunez | Social Worker | 4211 Avalon Blvd, Los Angeles, CA 90011-5622 | 2020-09-22 |
| 1740895168 | Veronica Isaac | Case Manager/Care Coordinator | 4211 Avalon Blvd, Los Angeles, CA 90011-5622 | 2020-09-11 |
| 1356952881 | Emily Wakeling | Counselor | 4211 Avalon Blvd, Los Angeles, CA 90011-5622 | 2020-08-10 |
| 1336758770 | Diana Ramos | Case Manager/Care Coordinator | 4211 Avalon Blvd, Los Angeles, CA 90011-5622 | 2020-07-30 |
| 1679199632 | Erin Hayden | Counselor | 4211 Avalon Blvd, Los Angeles, CA 90011-5622 | 2020-06-24 |
| 1861013344 | Katherine Rivas De Ollett | Nurse Practitioner | 4211 Avalon Blvd, Los Angeles, CA 90011-5622 | 2020-05-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184223935 | Commercial & Housing Support Aid | Assisted Living Facility | 120 - 122 East 24th Street, Los Angeles, CA 90011 | 2020-10-22 |
| 1295377711 | Joseph D Madrigal | Home Health Aide | 1977 Anzac Ave, Los Angeles, CA 90011 | 2019-10-16 |
| 1538641212 | Brenda Bahena | Community Health Worker | South Central Family Health Center, 4425 S. Central Ave, Los Angeles, CA 90011 | 2018-08-30 |
| 1083101851 | Bronwyn Anne Hazlewood | Student in an Organized Health Care Education/Training Program | 3740 Maple Ave, 1/2 B, Los Angeles, CA 90011 | 2018-04-17 |
| 1164941183 | Kimberly Denise Lister- Gutierrez | Counselor | 303 E 52nd Street, Los Angeles, CA 90011 | 2017-09-11 |
| 1205252533 | Jameese B Smith | Case Manager/Care Coordinator | 271 E. 43rd Street, Los Angeles, CA 90011 | 2014-03-11 |
| 1033533153 | Avalon-carver Community Center | Community/Behavioral Health | 4920 S. Avalon Blvd, Los Angeles, CA 90011 | 2014-02-10 |
| 1245672500 | Kellie D Bougard | Student in an Organized Health Care Education/Training Program | 4920 South Avalon Blvd, Los Angeles, CA 90011 | 2013-07-26 |
| 1578909404 | Ma. Jasmin F Binas | Nurse Practitioner | 2707 S.central Ave., Los Angeles, CA 90011 | 2013-05-19 |
| 1912343344 | California Assisted Pharmacy, Inc | Pharmacy | 646 E 28th St, Ste #1, Los Angeles, CA 90011 | 2013-05-13 |
| Find all providers in zip 90011 | ||||
| Taxonomy Code | 1835P1300X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Psychiatric |
| A licensed pharmacist who has demonstrated specialized knowledge and skill in optimizing care of patients with psychiatric illness by assessing and monitoring patients, recognizing drug-induced problems, and recommending appropriate treatment plans. |
| Notes: Source: Specialty certification and recertification program administered by Board of Pharmaceutical Specialties, www.bpsweb.org [7/1/2006: modified title, added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316009830 | Michael Francis Pondrom | Pharmacist | 590 N Vermont Ave, Los Angeles, CA 90004-2115 | 2006-12-14 |
| 1831271964 | Lisa Carol Holloman | Pharmacist | 11370 Wilshire Boulevard, Building 206 Room 230, Los Angeles, CA 90073 | 2006-10-19 |
| 1386628394 | Gregory K Kimura | Pharmacist | 765 W College St, Los Angeles, CA 90012-1181 | 2005-12-02 |
| 1417948423 | Mary A Gutierrez | Pharmacist | University of Southern California Sch of Pharmacy, 1985 Zonal Ave, Los Angeles, CA 90089-0001 | 2005-10-31 |
| 1457345662 | Michael Wincor | Pharmacist | 2146 Lyric Ave, Los Angeles, CA 90027-4754 | 2005-09-01 |
| 1508863812 | Julie Ann Dopheide | Pharmacist | Usc School of Pharmacy, 1985 Zonal Avenue, Los Angeles, CA 90089-0001 | 2005-06-30 |
| 1396112249 | Lily Lu | Pharmacist | 4211 Avalon Blvd, Los Angeles, CA 90011-5622 | 2015-08-26 |
| 1316314362 | Kimberly Appleby | Pharmacist | 4211 Avalon Blvd, Los Angeles, CA 90011-5622 | 2015-08-25 |
| 1275934242 | Michelle Xue Ding | Pharmacist | 529 Maple Ave, Los Angeles, CA 90013-1511 | 2014-09-10 |
| 1831411859 | Bosun Chung | Pharmacist | 11301 Wilshire Blvd, Building 500, Los Angeles, CA 90073-1003 | 2010-02-17 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90011 |
Please comment or provide details below to improve the information on LINE ORNELLA FASSUSIANKAM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.