MEDICARE: LIGAYA MACAYAON RESURRECCION FNP

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	95021396	CA
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	95021396	CA

General Provider Information

NPI Number	:	1508590324
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LIGAYA MACAYAON RESURRECCION FNP

Provider Business Mailing Address
First Line	:	4684 ONTARIO MILLS PKWY STE 200
Second Line	:
City	:	ONTARIO
State	:	CA
Zip	:	91764-5151
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4684 ONTARIO MILLS PKWY STE 200
Second Line	:
City	:	ONTARIO
State	:	CA
Zip	:	91764-5151
Country	:	US
Telephone Number	:	951-641-9648
Fax Number	:

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

Provider Enumeration Date	:	07/16/2022
Last Update Date	:	05/15/2026

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