Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Daisy Prom

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1295428100

Daisy Prom is a Nurse Practitioner in Los Angeles, California. Qualified in 2023, 3 years ago. Practices with San Marino Psychiatric Associates Inc, a 6-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
3
Licensed in
CA
In the registry since
2023
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Practice location Address checks out

1891 Effie St
Los Angeles, CA 90026-1711
Phone: (424) 653-6697
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 95025343 (CA)

Record details

NPI number1295428100
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMay 29, 2023
Last updated in NPPESJune 13, 2024
Certification dateJune 13, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice San Marino Psychiatric Associates Inc — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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