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NPI Code Detail

MEDICARE: MARIA GUADALUPE FRAUSTO LVN

MEDICARE: MARIA GUADALUPE FRAUSTO LVN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164X00000XLicensed Vocational Nurse288558CA

General Provider Information

NPI Number : 1134958127
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIA GUADALUPE FRAUSTO LVN
Provider Business Mailing Address
First Line : 10021 FORRESTAL DR
Second Line :
City : HUNTINGTON BEACH
State : CA
Zip : 92646-3717
Country : US
Telephone Number : 714-800-0407
Fax Number :
Provider Business Practice Location Address
First Line : 12781 JOSEPHINE ST
Second Line :
City : GARDEN GROVE
State : CA
Zip : 92841-4622
Country : US
Telephone Number : 714-606-0853
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2024
Last Update Date : 07/29/2024

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