Individual provider Active NPI

Sousanna Lachtchouk, NP

  • Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1982654844
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP11055 Issued in CA
Practice address
6200 Wilshire Blvd
Suite 1212
Los Angeles, CA 90048-5813
Phone
(323) 933-7200
Fax
(323) 933-7250
NPI assigned
May 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP11055 CA Primary
Family Nurse Practitioner 363LF0000X NP11055 CA
Primary Care Nurse Practitioner 363LP2300X NP11055 CA

Addresses

Primary practice location

6200 Wilshire Blvd
Suite 1212
Los Angeles, CA 90048-5813

Mailing address

6200 Wilshire Blvd
Suite 1212
Los Angeles, CA 90048-5813
Phone (323) 933-7200

Other identifiers 1

IdentifierTypeStateIssuer
NP0110550MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11055CAMDPhysical Therapist
NP11055CAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Val Shulman M D Inc PastSince May 1, 2003 Accepting new patients
Westside Multi-Specialty Medical Group, Inc. Past Accepting new patients

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": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1982654844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 WILSHIRE BLVD",
            "address_2": "SUITE 1212",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485813",
            "telephone_number": "323-933-7200",
            "fax_number": "323-933-7250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 WILSHIRE BLVD",
            "address_2": "SUITE 1212",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485813",
            "telephone_number": "323-933-7200",
            "fax_number": "323-933-7250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACHTCHOUK",
        "first_name": "SOUSANNA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-11",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP11055",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP11055",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "NP11055",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP0110550",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.