Healthcare Provider Details

I. General information

NPI: 1508590324
Provider Name (Legal Business Name): LIGAYA MACAYAON RESURRECCION FNP-BC, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LIGAYA LIBANAN MACAYAON RN

II. Dates (important events)

Enumeration Date: 07/16/2022
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5455 GARDEN GROVE BLVD STE 200
WESTMINSTER CA
92683-8201
US

IV. Provider business mailing address

4684 ONTARIO MILLS PKWY STE 200
ONTARIO CA
91764-5151
US

V. Phone/Fax

Practice location:
  • Phone: 562-431-8822
  • Fax: 562-431-8875
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95021396
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95021396
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number688952
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: