Healthcare Provider Details

I. General information

NPI: 1063254357
Provider Name (Legal Business Name): LOURDES POSADAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2024
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2031 FALCON DR
FAIRFIELD CA
94533-2408
US

IV. Provider business mailing address

2031 FALCON DR
FAIRFIELD CA
94533-2408
US

V. Phone/Fax

Practice location:
  • Phone: 510-307-6848
  • Fax:
Mailing address:
  • Phone: 510-307-6848
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number771975
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: