MEDICARE: LEA ANN SIBUG ESPINOZA FNP-C

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
1	363LF0000X	Family Nurse Practitioner	NP95032722	CA

General Provider Information

NPI Number	:	1679399901
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEA ANN SIBUG ESPINOZA FNP-C

Provider Business Mailing Address
First Line	:	PO BOX 5494
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91117-0494
Country	:	US
Telephone Number	:	661-886-3058
Fax Number	:

Provider Business Practice Location Address
First Line	:	5424 WOODRUFF AVE
Second Line	:
City	:	LAKEWOOD
State	:	CA
Zip	:	90713-1533
Country	:	US
Telephone Number	:	562-452-0038
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/03/2024
Last Update Date	:	11/16/2025

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