Healthcare Provider Details

I. General information

NPI: 1356133524
Provider Name (Legal Business Name): PATRICIA ANN FAZA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2025
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44519 92ND ST E
LANCASTER CA
93535-8443
US

IV. Provider business mailing address

44519 92ND ST E
LANCASTER CA
93535-8443
US

V. Phone/Fax

Practice location:
  • Phone: 661-212-0513
  • Fax:
Mailing address:
  • Phone: 661-212-0513
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN95026083
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: