Annketse Berhanu Desta, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

569177 Issued in CA

Practice address

3751 Stocker St
Los Angeles, CA 90008-5101

Phone

(323) 298-3680

NPI assigned

Mar 18, 2010

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1268870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619222400000",
    "number": "1023332137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21730 S VERMONT AVE",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905022196",
            "telephone_number": "310-781-3431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3751 STOCKER ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900085101",
            "telephone_number": "323-298-3680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESTA",
        "first_name": "ANNKETSE",
        "middle_name": "BERHANU",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-18",
        "last_updated": "2021-04-24",
        "certification_date": "2021-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "569177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Helen Anne Desmond, PH.D.
• Matthew Kent Desmond, M.D.
• Renika Desmond
• Phillip Martin Desmuke
• Semret Dessalegn, PH.D.
• Yosef Desta
• Destinations to Recovery, LLC
• Emma Gini Destrube, L.AC.
• Theresa Renee Desvignes
• Desway Corporation

• Registered Nurse in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.