MEDICARE: LIZBETH LAGUNA

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	164X00000X	Licensed Vocational Nurse	728100	CA

General Provider Information

NPI Number	:	1639937964
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LIZBETH LAGUNA

Provider Business Mailing Address
First Line	:	3775 SOLOMON ISLAND RD
Second Line	:
City	:	WEST SACRAMENTO
State	:	CA
Zip	:	95691-5890
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3775 SOLOMON ISLAND RD
Second Line	:
City	:	WEST SACRAMENTO
State	:	CA
Zip	:	95691-5890
Country	:	US
Telephone Number	:	916-417-9182
Fax Number	:

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

Provider Enumeration Date	:	03/11/2024
Last Update Date	:	03/11/2024

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Directions to “ LIZBETH LAGUNA ” Practice Location

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