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Mrs. RAVEN SHENETTE MAYES JAMES ONA/MD/ARNP

Individual Provider (NPI-1) Active

Nurse Practitioner

Provider Information

NPI Number
1558829721
Provider Type
Individual Provider (NPI-1)
Credentials
ONA/MD/ARNP
Status
Active

Contact & Location

Address
2275 E MARIPOSA AVE, EL SEGUNDO, CA, 902455029
Phone
(310) 426-6000

Specialties & Taxonomies

Psychologist #50-2560
Optometrist License: MA #ONA21898
Technician/Technologist #CNA92737
Military Health Care Provider License: KY #7-0076
Military Health Care Provider License: DC #50-1454
Driver License: FL #M200-737-79-557-0
Emergency Medicine License: FL #50-2560
Nuclear Medicine License: FL #50-2560
Clinic/Center License: GA #50-4007
Department of Veterans Affairs (VA) Pharmacy License: FL #50-2560
Physician Assistant
Nurse Practitioner License: CA #CEP15022
Nurse Practitioner License: AL #ABNP1418
Nurse Practitioner Primary License: FL #FLAPN559215

All Addresses

LOCATION

2275 E MARIPOSA AVE

EL SEGUNDO, CA, 902455029

(310) 426-6000

MAILING

PO BOX 2303

HAWTHORNE, FL, 326402303

(352) 271-5000