Healthcare Provider Details

I. General information

NPI: 1780016196
Provider Name (Legal Business Name): LIGAYA OBERES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2013
Last Update Date: 08/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 N LAKE AVE SUITE 800
PASADENA CA
91101-1848
US

IV. Provider business mailing address

155 N LAKE AVE SUITE 800
PASADENA CA
91101-1848
US

V. Phone/Fax

Practice location:
  • Phone: 626-818-5906
  • Fax:
Mailing address:
  • Phone: 626-818-5906
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number761227
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: