Healthcare Provider Details

I. General information

NPI: 1952507014
Provider Name (Legal Business Name): MARIA CECILIA LABOR CAMPOSANO LVN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2007
Last Update Date: 09/20/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5333 PARK HIGHLANDS BLVD
CONCORD CA
94521-3704
US

IV. Provider business mailing address

5333 PARK HIGHLANDS BLVD APT 54
CONCORD CA
94521-3721
US

V. Phone/Fax

Practice location:
  • Phone: 540-538-3618
  • Fax:
Mailing address:
  • Phone: 540-538-3618
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number261711
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: