| Doctor Name: | LYNN COATES-LEISEN |
| NPI Number: | 1134523558 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSN, APRN, FNP-C |
| License Number: | 95001441 |
| Business Practice Address: | 1000 Newbury Rd Ste 210 Newbury Park, CA - 913206441 |
| Business Phone Number: | 8052149900 |
| Business Fax Number: | |
| Mailing Address: | 1000 Newbury Rd Ste 210, NEWBURY PARK |
| State: | CA |
| Postal Code: | 913206441 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 10/14/2014 |
| NPI Last Update Date: | 12/18/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 95001441 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |