Logan Wellness Advanced Nursing Practice Corp

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

LOGAN WELLNESS ADVANCED NURSING PRACTICE CORP

Practice address

538 N Detroit St
Los Angeles, CA 90036-1949

Phone

(310) 751-1080

Fax

(844) 941-1989

NPI assigned

Jan 13, 2020

Organization subpart

No

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

Authorized official

Name

Mark Alan Logan, NP

Title

President

Phone

(310) 751-1080

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1578873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704153600000",
    "number": "1245870799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "538 N DETROIT ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900361949",
            "telephone_number": "310-751-1080",
            "fax_number": "844-941-1989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "538 N DETROIT ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900361949",
            "telephone_number": "310-751-1080",
            "fax_number": "844-941-1989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOGAN WELLNESS ADVANCED NURSING PRACTICE CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-13",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A",
        "authorized_official_last_name": "LOGAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-751-1080",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tammy P. Lofton
• Katherine Loftus
• Lindsey Loftus, M.S.
• Amir N. Lofty, MD
• Logan Optometrics, Inc.
• Anthony Louis Logan II
• Bryon Logan
• Deborah Lorraine Logan
• Deirdre Dene Logan, M.D.
• Gabrielle Logan

• Psychiatric/Mental Health Nurse Practitioner in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2024; 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.