Healthcare Provider Details

I. General information

NPI: 1639921232
Provider Name (Legal Business Name): LIZETTE LAZABAL SCHAEFER MSN-FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2024
Last Update Date: 04/05/2024
Certification Date: 04/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

627 W AVENUE Q STE D
PALMDALE CA
93551-3891
US

IV. Provider business mailing address

627 W AVENUE Q
PALMDALE CA
93551-3891
US

V. Phone/Fax

Practice location:
  • Phone: 661-810-1850
  • Fax:
Mailing address:
  • Phone: 661-810-1850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95029577
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: