Healthcare Provider Details

I. General information

NPI: 1528563582
Provider Name (Legal Business Name): LALAINE ABRAJANO GARSULA FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LALAINE SURLA ABRAJANO

II. Dates (important events)

Enumeration Date: 03/29/2018
Last Update Date: 04/24/2025
Certification Date: 04/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2131 HERNDON AVE STE 103
CLOVIS CA
93611-6304
US

IV. Provider business mailing address

2131 HERNDON AVE STE 103
CLOVIS CA
93611-6304
US

V. Phone/Fax

Practice location:
  • Phone: 832-604-3771
  • Fax:
Mailing address:
  • Phone: 832-604-3771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95008403
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: