MEDICARE: MRS. ELIZABETH BILLALVA FNP-BC

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
1	363LF0000X	Family Nurse Practitioner	95022617	CA

General Provider Information

NPI Number	:	1255053047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ELIZABETH BILLALVA FNP-BC

Provider Business Mailing Address
First Line	:	PO BOX 35380
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89133-5380
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	22386 CAMINITO MADERA
Second Line	:
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-1638
Country	:	US
Telephone Number	:	714-225-8639
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/19/2022
Last Update Date	:	04/13/2026

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