Provider Demographics
NPI:1871741488
Name:RECZEK, VERONICA C (NP)
Entity type:Individual
Prefix:MRS
First Name:VERONICA
Middle Name:C
Last Name:RECZEK
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:2143 S SEPULVEDA BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-5733
Mailing Address - Country:US
Mailing Address - Phone:310-575-3100
Mailing Address - Fax:310-575-3102
Practice Address - Street 1:2143 S SEPULVEDA BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-5733
Practice Address - Country:US
Practice Address - Phone:310-575-3100
Practice Address - Fax:310-575-3102
Is Sole Proprietor?:No
Enumeration Date:2008-09-08
Last Update Date:2011-06-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CANP18411363L00000X
CA18411363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner