Michele Vertucci, PA-C/NP

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA11454 Issued in CA

Practice address

910 Vine St
Los Angeles, CA 90038-2702

Phone

(323) 461-3106

Fax

(323) 461-3109

NPI assigned

Mar 21, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Physician Assistant

State licenses

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

{
    "created_epoch": "1332288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364342400000",
    "number": "1588939672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 VINE ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900382702",
            "telephone_number": "323-461-3106",
            "fax_number": "323-461-3109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 VINE ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900382702",
            "telephone_number": "323-461-3106",
            "fax_number": "323-461-3109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERTUCCI",
        "first_name": "MICHELE",
        "credential": "PA-C/NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-21",
        "last_updated": "2013-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA11454",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "308876",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Vertner J. White Dental Corporation
• Verupath Logistics, LLC
• Helena Athina Vervaet, MD
• Lia Ariane Verzatt, LMFT
• Robert Allen Vescio, M.D.
• Michael Vesely, D.C.

• Physician Assistant in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2013; 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.