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General NPI Number Information
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NPI Number | 1437430675
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Entity Type | Organization
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Legal Business Name | LP.A. & T. CORPORATION
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Dates
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Enumeration Date | 09/01/2011
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Last Update Date | 09/01/2011
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Provider Practice Location Address
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Address Line | 1262 DIXON WAY
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City | CHULA VISTA
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State | CA
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Zip | 91911
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Country | US
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Telephone | 619-426-6357
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Fax | 619-422-1805
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Provider Business Mailing Address
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Address Line | 1262 DIXON WAY
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City | CHULA VISTA
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State | CA
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Zip | 91911
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Country | US
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Telephone | 619-426-6357
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Fax | 619-422-1805
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Authorized Official
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Title or Position | PRESIDENT-OWNER
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Name | MRS. LIBERTY CRUZ NELSON
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Credential | RN-BSN/DON/ADMINISTR
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Telephone | 619-216-6357
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164X00000X
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Taxonomy Name | Licensed Vocational Nurse
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License Number | VN168658
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN301810
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License Number State | CA
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