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NPI Code Detail

MEDICARE: NATALIE DESIREE CANARILLO LVN

MEDICARE: NATALIE DESIREE CANARILLO 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 Nurse286184CA

General Provider Information

NPI Number : 1558293290
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATALIE DESIREE CANARILLO LVN
Provider Business Mailing Address
First Line : 3601 W SUNFLOWER AVE STE 200
Second Line :
City : SANTA ANA
State : CA
Zip : 92704-7916
Country : US
Telephone Number : 714-338-1115
Fax Number :
Provider Business Practice Location Address
First Line : 3601 W SUNFLOWER AVE STE 200
Second Line :
City : SANTA ANA
State : CA
Zip : 92704-7916
Country : US
Telephone Number : 714-338-1115
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/29/2026
Last Update Date : 05/29/2026

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