Active NPI
Beverly Jean Lassiter-Brown, PA, MPH
- Medical Physician Assistant
- Valencia, CA
National Provider Identifier
1962670141
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA 11128
- Practice address
- 25124 Springfield CT
Suite 200
Valencia, CA 91355-1085 - Phone
- (661) 678-2629
- Fax
- (661) 678-2729
- NPI assigned
- Feb 11, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA 11128 | CA | Primary |
Addresses
Primary practice location
25124 Springfield CT
Suite 200
Valencia, CA 91355-1085
Mailing address
426 E 45TH St
Long Beach, CA 90807-1418
Phone (310) 748-7295
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA 11128 | CA | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202688000000",
"number": "1962670141",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "426 E 45TH ST",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908071418",
"telephone_number": "310-748-7295"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25124 SPRINGFIELD CT",
"address_2": "SUITE 200",
"city": "VALENCIA",
"state": "CA",
"postal_code": "913551085",
"telephone_number": "661-678-2629",
"fax_number": "661-678-2729"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LASSITER-BROWN",
"first_name": "BEVERLY",
"middle_name": "JEAN",
"name_prefix": "Prof.",
"credential": "PA, MPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-02-11",
"last_updated": "2008-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CA",
"license": "PA 11128",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Valencia, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.