Healthcare Provider Details

I. General information

NPI: 1225244429
Provider Name (Legal Business Name): VERONICA BURNEO TINGZON RN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 09/05/2026
Certification Date: 09/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16838 W HOPE DR
SURPRISE AZ
85388-6133
US

IV. Provider business mailing address

16838 W HOPE DR
SURPRISE AZ
85388-6133
US

V. Phone/Fax

Practice location:
  • Phone: 619-395-3960
  • Fax:
Mailing address:
  • Phone: 619-395-3960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberL36104
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95262551
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number317830
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: