Active NPI
Leila Eileen Miranda Lavertu, FNP
- Family Nurse Practitioner
- Torrance, CA
National Provider Identifier
1700163086
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 17690
- Practice address
- 4101 Torrance Blvd
Torrance, CA 90503-4607 - Phone
- (310) 303-5600
- NPI assigned
- Nov 15, 2011
- Last updated
- Nov 15, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 17690 | CA | Primary |
Addresses
Primary practice location
4101 Torrance Blvd
Torrance, CA 90503-4607
Mailing address
28109 Highridge Rd Apt 10
Rolling Hills Estates, CA 90275-3466
Phone (310) 544-5143
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 1, 2020 through Jul 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1321315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321315200000",
"number": "1700163086",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28109 HIGHRIDGE RD APT 10",
"city": "ROLLING HILLS ESTATES",
"state": "CA",
"postal_code": "902753466",
"telephone_number": "310-544-5143"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4101 TORRANCE BLVD",
"city": "TORRANCE",
"state": "CA",
"postal_code": "905034607",
"telephone_number": "310-303-5600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIRANDA LAVERTU",
"first_name": "LEILA",
"middle_name": "EILEEN",
"name_prefix": "Mrs.",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-11-15",
"last_updated": "2011-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "17690",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Torrance, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.