MEDICARE: ALEXANDRA EMPERATRIZ SEGURA 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
1	171M00000X	Case Manager/Care Coordinator	206000	CA

General Provider Information

NPI Number	:	1407192669
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRA EMPERATRIZ SEGURA LVN

Provider Business Mailing Address
First Line	:	10121 BURNET AVE
Second Line	:
City	:	MISSION HILLS
State	:	CA
Zip	:	91345-2715
Country	:	US
Telephone Number	:	818-263-7991
Fax Number	:	818-885-9575

Provider Business Practice Location Address
First Line	:	10121 BURNET AVE
Second Line	:
City	:	MISSION HILLS
State	:	CA
Zip	:	91345-2715
Country	:	US
Telephone Number	:	818-263-7991
Fax Number	:	818-885-9575

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

Provider Enumeration Date	:	12/17/2012
Last Update Date	:	12/17/2012

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