Individual provider Active NPI

Annalissa Llavan Flores, NP

  • Nurse Practitioner
  • Redondo Beach, CA
National Provider Identifier
1740626100
Registry record updated Oct 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
23036 Issued in CA
Practice address
1959 Kingsdale Ave
Redondo Beach, CA 90278-3417
Phone
(310) 214-1000
Fax
(310) 214-8540
NPI assigned
May 13, 2013
Last updated
Oct 1, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 23036 CA Primary

Addresses

Primary practice location

1959 Kingsdale Ave
Redondo Beach, CA 90278-3417

Mailing address

4444 Spencer St
Torrance, CA 90503-2435
Phone (310) 921-6594

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130725000385 CA Practitioner - Nurse Practitioner 5890936363 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of Los AngelesGroup PAC ID 1850296534, 395 clinicians

Practice addresses (Care Compare)

24432 Muirlands Blvd
Suite 101
Lake Forest, CA 92630-3939
Phone (916) 897-7321

2829 S Grand Ave
Los Angeles, CA 90007-3304
Phone (213) 699-7013

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
23036CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Soma Medical Group CurrentSince Jun 5, 2013 Accepting new patients
County of Los Angeles CurrentSince Oct 7, 2018 Accepting new patients
County of Los Angeles CurrentSince Oct 7, 2018 Accepting new patients
County of Los Angeles Current Accepting new patients
Roohbakhsh Maher DPM. Inc PastSince Jun 5, 2013 Accepting new patients

Locations

1000 S Fremont Ave
Unit 9
Alhambra, CA 91803

2829 S Grand Ave
Los Angeles, CA 90007
Phone (213) 699-7000

1959 Kingsdale Ave
Redondo Beach, CA 90278
Phone (310) 214-1000

Organizations & group practices 7

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

NPI Registry JSON

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

{
    "created_epoch": "1368403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790812800000",
    "number": "1740626100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4444 SPENCER ST",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905032435",
            "telephone_number": "310-921-6594",
            "fax_number": "310-921-6594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 KINGSDALE AVE",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902783417",
            "telephone_number": "310-214-1000",
            "fax_number": "310-214-8540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLORES",
        "first_name": "ANNALISSA",
        "middle_name": "LLAVAN",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-13",
        "last_updated": "2026-10-01",
        "certification_date": "2026-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "23036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redondo Beach, CA

Sources for this page

Verify at the official NPI Registry.