Individual provider · NPI-1

Katrina Lugtu Dijamco, CPNP

Nurse Practitioner, Pediatrics · Stockton, CA

NPI number1528508173
StatusActive
Last updated in NPPESMar 1, 2017

Details

NPI
1528508173
Entity type
Individual (NPI-1)
Name
Katrina Lugtu Dijamco
Credential
CPNP
Sex
Female
Sole proprietor
No
Enumeration date
Mar 1, 2017
Last updated
Mar 1, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LP0200X Nurse Practitioner, Pediatrics95006275CAYes

Practice location

7210 Murray Dr
Stockton, CA 95210-3339

Phone 209-373-2800

Mailing address

15875 Devonwood Way
San Lorenzo, CA 94580-1463

Phone 510-329-2222

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