Healthcare Provider Details

I. General information

NPI: 1326950759
Provider Name (Legal Business Name): LYDIA TROXELL NBC-HWC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3535 LEBON DR APT 4308
SAN DIEGO CA
92122-6402
US

IV. Provider business mailing address

3535 LEBON DR APT 4308
SAN DIEGO CA
92122-6402
US

V. Phone/Fax

Practice location:
  • Phone: 909-744-2936
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License NumberA-4522238
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: