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NPI Code Detail

MEDICARE: LIGAYA PALAGANAS FONTANILLA RN

MEDICARE: LIGAYA PALAGANAS FONTANILLA RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WP0808XPsychiatric/Mental Health Registered Nurse267163CA

General Provider Information

NPI Number : 1275198798
Entity Type Code : Individual
Provider Name (Legal Business Name) : LIGAYA PALAGANAS FONTANILLA RN
Provider Business Mailing Address
First Line : 2900 E DEL MAR BLVD
Second Line :
City : PASADENA
State : CA
Zip : 91107-4375
Country : US
Telephone Number : 818-298-9616
Fax Number :
Provider Business Practice Location Address
First Line : 2900 E DEL MAR BLVD
Second Line :
City : PASADENA
State : CA
Zip : 91107-4375
Country : US
Telephone Number : 626-319-1310
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2019
Last Update Date : 05/09/2019

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