Healthcare Provider Details

I. General information

NPI: 1396679189
Provider Name (Legal Business Name): ELISABETH LEIGH LAWSON-ABREU RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 PICO AVE STE 250
SAN MARCOS CA
92069-3712
US

IV. Provider business mailing address

622 SHENANDOAH AVE
SAN MARCOS CA
92078-7918
US

V. Phone/Fax

Practice location:
  • Phone: 760-752-1299
  • Fax:
Mailing address:
  • Phone: 760-330-3792
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number705176
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: