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NPI Code Detail

MEDICARE: LACEY GRACIA

MEDICARE: LACEY GRACIA
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
1163W00000XRegistered Nurse95356422CA

General Provider Information

NPI Number : 1730011255
Entity Type Code : Individual
Provider Name (Legal Business Name) : LACEY GRACIA
Provider Business Mailing Address
First Line : 5181 BLUEGRASS WAY
Second Line :
City : OCEANSIDE
State : CA
Zip : 92057-1828
Country : US
Telephone Number : 785-614-3808
Fax Number :
Provider Business Practice Location Address
First Line : 5181 BLUEGRASS WAY
Second Line :
City : OCEANSIDE
State : CA
Zip : 92057-1828
Country : US
Telephone Number : 785-614-3808
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2026
Last Update Date : 06/01/2026

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Directions to “ LACEY GRACIA ” Practice Location

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