Provider Demographics
NPI:1255739835
Name:EISENBERG, AMALIA ARASULA (ARNP)
Entity type:Individual
Prefix:MRS
First Name:AMALIA
Middle Name:ARASULA
Last Name:EISENBERG
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 SANTA MONICA BLVD
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404
Mailing Address - Country:US
Mailing Address - Phone:310-582-7450
Mailing Address - Fax:310-582-7495
Practice Address - Street 1:2121 SANTA MONICA BLVD
Practice Address - Street 2:PROVIDENCE ST. JOHN'S HEALTH CENTER
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404
Practice Address - Country:US
Practice Address - Phone:310-582-7450
Practice Address - Fax:310-582-7495
Is Sole Proprietor?:No
Enumeration Date:2014-12-12
Last Update Date:2014-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19334363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care