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General NPI Number Information
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NPI Number | 1780521062
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Entity Type | Individual
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Provider Name | JUVANESSA LAKILAK MSN, RN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 05/04/2026
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Last Update Date | 05/04/2026
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Provider Practice Location Address
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Address Line | 3801 MIRANDA AVE
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City | PALO ALTO
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State | CA
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Zip | 94304-1290
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Country | US
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Telephone | 650-493-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 7 41ST AVE UNIT 121
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City | SAN MATEO
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State | CA
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Zip | 94403-5105
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Country | US
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Telephone |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 95172105
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 95038960
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License Number State | CA
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