Search › California › 183700000X
Camilla Divina Licerio
NPI 1811580137 · on the registry since 2021
Practice
- Address
- 2732 W Olympic Blvd
Los Angeles, CA 90006 - Phone
- (213) 382-6391
- Fax
- (213) 387-7475
- Organisation at this address
- Sang J Lee
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 4
Registry record
- Primary taxonomy
- 183700000X
183700000X
- Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2021-02-26
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California