Healthcare Provider Details
I. General information
NPI: 1124934849
Provider Name (Legal Business Name): LILYPAD HEALTH PROFESSIONAL NURSING CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
28 CAVALRY CT
DANVILLE CA
94526-3903
US
IV. Provider business mailing address
28 CAVALRY CT
DANVILLE CA
94526-3903
US
V. Phone/Fax
- Phone: 925-489-0946
- Fax: 949-948-0676
- Phone: 925-330-5519
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP2300X |
| Taxonomy | Primary Care Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SHANNON
RENEE
GIGOUNAS
Title or Position: OWNER, FAMILY NURSE PRACTITIONER
Credential: DNP, RN, FNP-BC
Phone: 925-330-5519