Healthcare Provider Details

I. General information

NPI: 1134476799
Provider Name (Legal Business Name): LESSETTE PLASCENCIA CETTO RNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2012
Last Update Date: 04/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44900 60TH ST W
LANCASTER CA
93536-7618
US

IV. Provider business mailing address

44900 60TH ST W
LANCASTER CA
93536-7618
US

V. Phone/Fax

Practice location:
  • Phone: 661-945-8303
  • Fax:
Mailing address:
  • Phone: 661-945-8303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number20623
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: