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General NPI Number Information
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NPI Number | 1083858401
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Entity Type | Individual
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Provider Name | MITZI LLAMAS CABALTICA NP
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Gender | Female
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Dates
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Enumeration Date | 04/29/2009
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Last Update Date | 12/03/2024
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Provider Practice Location Address
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Address Line | 500 N STATE COLLEGE BLVD STE 1100
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City | ORANGE
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State | CA
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Zip | 92868-1625
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Country | US
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Telephone | 909-901-3987
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Fax |
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Provider Business Mailing Address
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Address Line | 500 N STATE COLLEGE BLVD STE 1100
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City | ORANGE
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State | CA
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Zip | 92868-1625
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Country | US
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Telephone | 909-901-3987
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 608759
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License Number State | CA
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