Healthcare Provider Details

I. General information

NPI: 1346180791
Provider Name (Legal Business Name): GAVINA DE LEON LAJARA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2026
Last Update Date: 03/28/2026
Certification Date: 03/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 ADDISON RD APT 10
CAPITOL HEIGHTS MD
20743-1042
US

IV. Provider business mailing address

4800 ADDISON RD APT 10
CAPITOL HEIGHTS MD
20743-1042
US

V. Phone/Fax

Practice location:
  • Phone: 340-514-2665
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: