Healthcare Provider Details

I. General information

NPI: 1902798804
Provider Name (Legal Business Name): LANAY HAZZARD-MARCELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2025
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 SPORTFISHER DR
OCEANSIDE CA
92054-2550
US

IV. Provider business mailing address

1100 SPORTFISHER DR
OCEANSIDE CA
92054-2550
US

V. Phone/Fax

Practice location:
  • Phone: 760-439-6702
  • Fax:
Mailing address:
  • Phone: 760-439-6702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number139352
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: