Individual provider Active NPI

Leitha Hakanson

  • Family Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1700767944
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
13840 Issued in CA
Practice address
625 W College St Ste 105
Los Angeles, CA 90012-1650
Phone
(213) 265-7433
Fax
(213) 265-7531
NPI assigned
Sep 11, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 13840 CA Primary

Addresses

Primary practice location

625 W College St Ste 105
Los Angeles, CA 90012-1650

Mailing address

17343 Burma St
Encino, CA 91316-1334
Phone (818) 486-9075

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260327003367 CA Practitioner - Nurse Practitioner 3779068739 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

645 Aerick St
Suite 3
Inglewood, CA 90301-1976

8623 Moody St
Cypress, CA 90630-2239

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13840CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
High Desert Womens Memorial Medical Center Apc CurrentSince Sep 14, 2025 Accepting new patients

Locations

625 W College St
Ste 105
Los Angeles, CA 90012
Phone (213) 265-7433

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1757548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1700767944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17343 BURMA ST",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913161334",
            "telephone_number": "818-486-9075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 W COLLEGE ST STE 105",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900121650",
            "telephone_number": "213-265-7433",
            "fax_number": "213-265-7531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAKANSON",
        "first_name": "LEITHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-11",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "13840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.