Healthcare Provider Details

I. General information

NPI: 1083525943
Provider Name (Legal Business Name): PAOLA LORENA VASQUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1047 W ROSAMOND BLVD APT 60
ROSAMOND CA
93560-7551
US

IV. Provider business mailing address

1047 W ROSAMOND BLVD
ROSAMOND CA
93560-7498
US

V. Phone/Fax

Practice location:
  • Phone: 661-404-0744
  • Fax:
Mailing address:
  • Phone: 661-404-0744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: